• Title/Summary/Keyword: Neurological physical therapy

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단기 집단 복합중재가 정상 노인의 인지기능 및 우울에 미치는 영향 (Effects of a Short-term Multimodal Group Intervention Program on Cognitive Function and Depression of the Elderly)

  • 정범진;최유진
    • 재활치료과학
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    • 제8권3호
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    • pp.57-68
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    • 2019
  • 목적: 신체활동과 인지운동, 사회적 상호작용을 혼합한 단기 집단 복합중재가 75세 이상의 고령 정상 노인의 인지기능과 우울 수준에 미치는 영향을 알아보고자 하였다. 연구방법: 본 연구 설계는 단일 집단 사전-사후 설계(one group pretest-posttest design)로 중재는 회당 70분, 주 1회, 총 4회기 동안 실시하였다. 중재 전과 후의 인지기능과 우울 수준, 신체기능의 변화를 비교하기 위해서 치매 선별용 간이 정신상태검사(Mini-Mental State Examination-Dementia Screening; MMSE-DS)와 단축형 노인우울척도(Short Form for Geriatric Depression Scale; SGDS), 버그균형척도(Berg Balance Scale; BBS)를 사용하였다. 결과: 75세 이상의 고령 정상노인에게 집단 복합중재를 적용한 후 인지기능은 통계적으로 유의미한 향상이 있었고(p<.01), 우울 수준은 통계적으로 유의미한 감소가 있었다(p<.05). 균형수준도 중재 전$46.83{\pm}9.11$점에서 중재 후 $48.08{\pm}7.00$점으로 평가점수의 증가는 있었으나, 통계적으로 유의미하지는 않았다(p>.05). 결론: 신체활동과 인지운동, 사회적 상호작용을 혼합한 단기 집단 복합중재는 75세 이상의 고령 정상노인의 인지기능의 저하를 늦추고 우울수준을 감소시키는데 유의한 효과가 있었다. 본 연구는 정상노인들의 치매, 우울 예방을 위한 중재에 있어서 보다 체계적인 중재를 제공하기 위한 근거를 제시한다는 점에 의의가 있다. 향후 연구에서는 작업치료사에 의한 전문적인 치료에 대한 효과연구와 실험군-대조군 연구를 통해 효과입증이 이루어져야 할 것이다.

목 및 가슴신경뿌리병증의 임상적 고찰: 비침습적 중재시술치료 (Clinical Characteristics of Cervical and Thoracic Radiculopathies: Non-Invasive Interventional Therapy)

  • 노학재;이상헌;김병조
    • Annals of Clinical Neurophysiology
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    • 제10권2호
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    • pp.83-97
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    • 2008
  • Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

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Sarcopenia: Nutrition and Related Diseases

  • Du, Yang;No, Jae Kyung
    • 한국조리학회지
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    • 제23권1호
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    • pp.66-78
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    • 2017
  • "Sarcopenia", sarcopenia is an old age syndrome, and used to describe the reduction of skeletal muscle. Initially, it was thought that sarcopenia was only a senile disease characterized by degeneration of muscle tissue. However, its cause is widely regarded as multifactorial, with neurological decline, hormonal changes, inflammatory pathway activation, declines in activity, chronic illness, fatty infiltration, and poor nutrition, all shown to be contributing factors. Skeletal muscle mass can be measured by a variety of methods, currently, the commonly used methods are dual-energy X-ray scanning (DXA), computer tomography (CT), magnetic resonance imaging (MRI), etc. Muscular skeletal disorders can also be assessed by measuring appendicular skeletal muscle (ASM), particularly muscle tissue content. At the same time, sarcopenia refers to skeletal muscle cell denervation, mitochondrial dysfunction, inflammation, hormone synthesis and secretion changes and a series of consequences caused by the above process and is a progressive loss of skeletal muscle syndrome, which can lead to the decrease of muscle strength, physical and functional disorders, and increase the risk of death. Sarcopenia is mainly associated with the aging process, but also related to other causes such as severe malnutrition, neurodegenerative diseases, and disuse and endocrine diseases associated with muscular dystrophy, and it is the comprehensive results of multi-factors, so it is difficult to define that sarcopenia is caused by a specific disease. With the aging problem of the population, the incidence of this disease is increasingly common, and seriously affects the quality of the life of the elderly. This paper reviews the etiology and pathogenesis of myopathy, screening methods and diagnosis, the influence of eating habits, etc, and hopes to provide reference for the diagnosis and treatment of this disease. At present, adequate nutrition and targeted exercise remain the gold standard for the therapy of sarcopenia.

반사성 교감신경이영양증후군(RSDS)으로 내원한 환자 1례에 대한 보고 (A Case Report of Reflex Sympathetic Dystrophy Syndrome)

  • 문형철;김성남;이성용;김성철;이상민;임정아
    • Journal of Acupuncture Research
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    • 제22권6호
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    • pp.241-249
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    • 2005
  • Objectives : The purpose of this case is to report the improvement after treatment about patient with Reflex sympathetic dystrophy syndrome. Methods : We treated the patient with acupuncture therapy and Herbal medication from 12th October 2004 to 20th June 2005 by evaluating shoulder function with VAS score, shoulder joint ROM and mannual muscle test(MMT). Results : After treatment, this patient achieved excellent outcome following the technique, showing that clinical symptom as like pain, swelling, paresthesia, color tone change was almost disappeared, and there was improvement of ROM and MMT Conclusion : Reflex Sympathetic Dystrophy Syndrome (RSDS) also known as Complex Regional Pain Syndrome (CRPS) is a chronic neurological syndrome characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling, extreme sensitivity to touch. Oriental medical treatment for Reflex Sympathetic Dystrophy Syndrome resulted in satisfactory results by diminishing the symptoms progressively during the thirty two weeks of treatment. Differential diagnosis was based on careful physical examination. More research of Reflex Sympathetic Dystrophy Syndrome is needed.

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미노싸이클린과 수영훈련이 척수손상 흰쥐의 운동기능 및 Bcl-2발현에 미치는 영향 (The Effect of Swimming and Minocycline on Motor Function and Expression of Bcl-2 after Spinal Cord Injury in the Rats)

  • 하미숙;하배진
    • 생명과학회지
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    • 제19권10호
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    • pp.1489-1494
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    • 2009
  • 본 연구는 척수 앞뿔의 세포손상을 준 흰쥐를 대상으로 수영운동과 미노싸이클린의 치료적 중재를 통해 운동기능과 신경계의 회복을 알아보고 운동에 의한 척수손상의 신경학적 회복기전을 밝히는 것의 목적이 있다. 본 연구의 진행은 Sprague-Dawley계 흰쥐 28마리의 허리뼈 1-2번 사이에 6-OHDA로 척수손상을 일으킨 다음 3일 후에 치료를 시작하였다. 수영은 주 5회 15분간 운동을 실시하고 미노싸이클린은 척수손상을 유발한 후 12시간마다 복강내 주입하였다. 척수손상을 유발한 후 치료를 시작하기 전에 운동기능의 평가를 시행하며 2주 동안 4번의 검사가 이루어졌으며, Bcl-2 발현에 관한 측정은 2주간 치료 후 검사하였다. BBB 척도에서 대조군에 비해 실험군에서 7일에 차이가 있었으며, 14일에는 II, III군에 비해 실험군 Ⅳ군에서 증가하였다. Bcl-2의 면역학적 소견에서 실험군 모두 대조군에 비해 척수 앞뿔에서 Bcl-2의 발현이 증가되었으며, 실험군 Ⅳ에서 가장 많은 Bcl-2의 발현이 관찰되었다. 척수손상 후 미노싸이클린과 수영은 행동학적, 면역학적 소견을 긍정적으로 개선시키는 것으로 나타났으며, 수영과 미노싸이클린을 함께 실시한 경우 세포사멸의 감소와 운동기능의 회복에 효과가 있음을 알 수 있었다.

HPRT 유전자 돌연변이에 의한 HPRT 부분결핍증 1례 (Partial HPRT Deficiency Due to a Missense Mutation in the HPRT Gene)

  • 양주희;박민혁;김덕수;심재원;심정연;정혜림;유한욱;박문수
    • Childhood Kidney Diseases
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    • 제7권1호
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    • pp.86-90
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    • 2003
  • 저자들은 출생시부터 지속된 육안적 오렌지색소변 결정체를 주소로 내원한 8개월된 남아에서 HPRT 유전자의 돌연변이에 의한 HPRT 부분결핍증 1례를 경험하였기에 이를 문헌고찰과 함께 보고한다.

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급성 횡단성 척수염으로 진단된 비증 환자의 치험 1례 (Clinical Study on 1 Case of Patient with Arthalgia Syndrome Diagnosed as Acute Transverse Myelitis)

  • 이승현;필감흔;조은희
    • 동의생리병리학회지
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    • 제21권6호
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    • pp.1663-1669
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    • 2007
  • Acute transverse myelitis(ATM) is defined as an acute intramedullary dysfunction of the spinal cord, ascendng or static involving both halves of the cord and appearing without any history of previous neurological diseases due to traumatic accident, tumor of all kind, encephalitis and of course excluding all possible viral, bacterial and fungal infection. It is mainly characterized by acute motor disorder of both limbs in respect to which spinal segments are affected as well as sensory disorder and dysuria & dyschezia. The exact cause is unknown, however it is recently suggested that immunological factors are highly involved. It has been reported by several reliable sources that it is often accompanied by immunological diseases such as systemic lupus erythematosus(SLE). As treatments non steroid anti-inflammatory drugs(NSAIDS) are primarily recommended as to steroids, limited doses are injected only with the proper prescription from the physician. Operative methods are not options as traumatic accidents and tumors are excluded as factors. To enhance muscle strength and prevent articular contracture physical therapy and passive exercise is imperative. The following patient whose chief complaints were mainly about hypoesthesia of Rt. lower limb and stiffness of phalanges of both fingers as well as to weakness of lower extermity. Therefore it has been diagnosed as arthalgia syndrome. In oriental medicine factors such as wind evil heat-evil, dampness-heat evil, cold evil cause the arthalgia syndrome. In this case the patient was diagnosed as dampness-heat evil and herbal medicine Chunglijagam-Tang and Dong-Qi acupuncture was applied to treat bladder disorder.

깃각 자동측정 프로그램의 신뢰도와 타당도 평가 (An Evaluation of the Reliability and Validity of the Automatic Pennation Angle Measuring Program)

  • 김종순
    • PNF and Movement
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    • 제17권2호
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    • pp.329-337
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    • 2019
  • Purpose: Ultrasound imaging is commonly used to measure the pennation angle of human skeletal muscles in vivo. However, manual assessment of the pennation angle using ultrasound images is subjective and time-consuming and requires a high level of examiner skill. The architectural analysis of human skeletal muscles is thus challenging. Automated approaches using image processing techniques are therefore required to estimate the pennation angle in ultrasound images. The purpose of this study was thus to assess the intra-tester and inter-tester reliability and validity of the pennation angle using an automatic measurement program. Methods: Twenty-two healthy young adults (mean age = 22.55 years) with no medical history of neurological or musculoskeletal disorders voluntarily participated in this study. Ultrasound imaging was used to measure the pennation angle of the gastrocnemius muscle at rest. One examiner acquired images from all the participants. The intra-tester and inter-tester reliability were evaluated using the intraclass correlation coefficient (ICC) to estimate reliability. Validity was measured using Pearson's correlation coefficient. Results: The intra-rater reliability was excellent for the automatic pennation angle measuring program and the manual pennation angle assessment method (ICC>0.95). The inter-rater reliability was also excellent for both methods (ICC>0.93). All the correlation coefficients for the automatic pennation angle measuring program and the manual pennation angle assessment method were 0.79, which indicated a significantly positive correlation (p<0.05). Conclusion: Pennation angle measurement using the automatic pennation angle measuring program showed acceptable reliability and validity. This study therefore demonstrated that the automatic measuring program was able to automatically measure the pennation angle of skeletal muscles using ultrasound images, and thus made it easy to investigate skeletal muscle architecture.

Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

  • Jeong, Ju-Young;Hwang, Tae-Sung;Song, Kun-Ho;Song, Joong-Hyun
    • 한국임상수의학회지
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    • 제39권5호
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    • pp.235-239
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    • 2022
  • A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

펠든크라이스 기법®을 적용한 신체 움직임 프로그램 설계 - 파킨슨병 환자를 중심으로 (Design of Body Movement Program with the Application of Feldenkrais Method® - Foucing on Parkinson's Disease)

  • 박소정
    • 트랜스-
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    • 제14권
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    • pp.35-63
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    • 2023
  • 파킨슨병은 신체 움직임을 담당하는 도파민의 부족으로 신체 기능의 장애로 기본적인 일상생활까지 영향을 미치는 퇴행성 신경질환이다. 현재 의술로는 완치가 힘들어 병의 지연과 예방 차원으로 운동치료에 관심을 모으고 있다. 이에 본 연구에서는 펠든크라이스 기법®을 파킨슨병 환자에게 적용하여 심신의 상태를 스스로 돌볼 수 있는 신체 움직임 프로그램을 설계하고 보급하는데 목적을 갖는다. 펠든크라이스 기법®은 신체 움직임을 이용한 심신 자각 학습 방법으로 신경가소성의 기능인 뇌와 행동을 연결하여 신경계를 재교육하는 방법론이다. 본 연구에서는 연구자가 개발하고 검증한 신체 움직임 프로그램을 펠든크라이스 기법®의 자각(⾃覺)에 초점을 맞추어 수정·보완하였다. 24회기의 신체 움직임 프로그램은 파킨슨병 환자의 자기관리능력을 향상하기 위해 5단계로 구성하였다. 첫 번째 단계는 자기 인식이고 두 번째 단계는 자기 관찰이다. 셋째, 자기조직화, 넷째, 자기 통제. 그리고 다섯 번째 단계는 자기 관리다. 전반적인 변화는 자신의 상태를 인식하고 내적 감각과 외적 환경의 변화를 감지하는 능력을 향상시킨다. 결론적으로 파킨슨병 환자에게 심신 기능의 향상과 자기관리가 가능한 신체 움직임 프로그램을 펠든크라이스 기법을 적용하여 설계하였다. 앞으로 설계된 프로그램을 현장 적용 가능성 여부는 후속과제로 남긴다. 나아가 노년층의 웰니스를 위한 움직임의 참고자료로 메타버스를 적용한 과학분야와의 융합적 협력을 통해 보다 폭넓게 확산될 수 있도록 체계적 구조를 구축할 필요가 있다.