• Title/Summary/Keyword: Outpatient rehabilitation

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Effects of Self-Checked Monitoring Home Exercises on Gait, Balance, Strength, and Activities of Daily Living in People with Parkinson's Disease

  • Lim, Chaegil
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.1
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    • pp.1940-1949
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    • 2020
  • Background: Self-checked monitoring home exercises are recommended for preventing falls among people with Parkinson's disease. However, as these home exercises are performed autonomously by patients without professional management, their accuracy and efficiency can be compromised. Objective: To investigate the effects of providing regular training sessions to patients and caregivers and of patient self-monitoring of exercise performance following the implementation of a self-checked monitoring exercise program for people with Parkinson's disease. Design: Randomized Pretest-Posttest Control Group Design. Methods: We provided regular self-checked monitoring home exercise and general home exercise programs to 30 participants for 12 weeks. Once a month at the first, fifth, and ninth-week sessions, a rehabilitation team attended the Parkinson's group education. In addition to the subject in the experimental group perform the home exercises program to provide feedback regarding the home exercises program and to carry out a self-monitoring checklist performance for 12 weeks. Results: The 10 m walk test, functional reach test, and sit to stand test and the modified Barthel index significantly improved in the self-checked monitoring home exercise group. Conclusion: These results suggest that self-checked home exercise programs, which facilitate safety and consistent performance of exercises at home, are beneficial for people with Parkinson's disease.

Effects of Korean Medicine Treatment on a Patient with Functional Scoliosis with an Abnormal Gait Pattern After Hip Injury: A Case Report

  • Gi, Yu-Mi;Kim, Tae-Gyu;Jo, Hoo-In;Choi, Jong-Ho;Park, Eun-Young;Lee, Soo-Kyung;Lee, June-Haeng;Kim, Min-Kyu;Lee, KeunJae;Yu, Ok-Cheol
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.282-285
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    • 2019
  • Scoliosis is a 3-dimensional spinal deformity defined as lateral curvature of the spine in the coronal plane of more than $10^{\circ}$. This study describes a case of functional scoliosis after hip injury. In this case, the patient fell whilst inline skating (June 2015) causing severe tilting of her spine, and left hip pain. She received outpatient treatment from July 14, 2015 to December 28, 2015. For approximately 5 months, acupuncture therapy was performed to relax the tension in both hips, Chuna therapy, and foot orthosis were applied to reduce the body's imbalance. Based on X-ray images, the Cobb angle had decreased from $14.73^{\circ}$ (pretreatment) to $1.90^{\circ}$ (posttreatment). This case report suggested that Korean medicine treatment could be an effective therapeutic choice for functional scoliosis.

Five Clinical Cases of Facial Chuna Manual Therapy with Korean Medicine Treatment for Acute Bell's Palsy

  • Jung Min Son;Hye Soo Youn;Eun Chang Lee;Choong Hyun Park;Sun Woo Kwon;Ji Yoon Lee;Da Young Han;Haeni Seo
    • Journal of Acupuncture Research
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    • v.40 no.1
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    • pp.67-77
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    • 2023
  • This study individually analyzed the effects of Korean Facial Chuna Manual Treatment (K-FCMT) combined with Korean medicine (KM) treatment (acupuncture, electroacupuncture, pharmacopuncture, and herbal medicine) on five patients with acute Bell's palsy who visited Dongsuwon Korean Medicine Hospital between August 1 and 31, 2022. During inpatient treatment, two of the five patients received K-FCMT 5-6 times a week, and the other three received the same frequency during outpatient treatment for approximately 2 weeks. Patients with a House-Brackmann grading scale (HBGS) score of ≤4 and Yanagihara unweighted grading system (Y-score) ≥7-8 began to recover after the 2nd-3rd sessions of K-FCMT, which entered the recovery phase quickly. As patients entered the recovery phase (7-9th sessions of K-FCMT), symptoms improved to HBGS scores of 1-2 and Y-scores of 35-40 points. This study suggests the possibility of applying K-FCMT combined with KM treatment to patients in the acute stage of Bell's palsy.

A Structural Equation Model on Social Re-Adjustment of Stroke Patients: Based on Roy's Adaptation Model (뇌졸중 환자의 사회재적응 구조모형: Roy의 적응모형에 기반하여)

  • Kim, Jungmi;Kim, Hwasoon
    • Journal of Korean Academy of Nursing
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    • v.53 no.4
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    • pp.480-495
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    • 2023
  • Purpose: This study aimed to develop and test a structural equation model on social re-adjustment of individuals with stroke based on a literature review and Roy's adaptation model. Methods: This study involved 321 participants who had a stroke and visited the outpatient department after discharge. The hypothetical model was developed based on Roy's adaptation model and a comprehensive review of previous literature on the topic. The model comprised four exogenous variables (neurological damage, gender [man], age, and social support) and five endogenous variables (activities of daily living, acceptance of disability, depression, rehabilitation motivation, and social re-adjustment). The data were analyzed using SPSS Windows software version 22.0 and AMOS 23.0. Results: Out of 28 research hypotheses, 18 were supported, and they indicated approximately 64% probability of social re-adjustment. Social re-adjustment is directly and significantly affected by age, social support, activities of daily living, and depression. Social re-adjustment is indirectly affected by neurological impairment, gender (men), age, social support, and rehabilitation motivation. Conclusion: Continuous assistance and care should be provided for individuals with disabilities caused by sudden neurological damage to facilitate gradual improvement in their social re-adjustment. To enhance social re-adjustment, especially among older adults, newly developed interventions should focus on improving their activities of daily living, preventing depression, and enhancing support from family and healthcare personnel.

Comparison of Efficacy between Acupuncture Treatment and Collaborative Treatment with Prednisolone on Acute Bell's Palsy (급성 Bell's Palsy의 침 치료와 Prednisolone을 병행한 협진 치료의 효과 비교)

  • Yi, Joo-Il;Kim, Hae-Jin;Ryu, Eun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.3
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    • pp.125-132
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    • 2013
  • Objectives The purpose of this study was to compare the effects of acupuncture treatment with those of collaborative treatment regarding acute Bell's palsy. Methods Twenty-six patients who received outpatient treatment between March 2012 and February 2013 were divided into 2 groups. The East-West treatment group (EW group, n=12) received prednisolone and then acupuncture afterwards. The Eastern treatment group (E group, n=14) received just acupuncture. Acupuncture was administered 3 to 4 times a week, and both groups were educated to practice facial muscle exercises at home. Evaluations were made before treatment, after 1 week, 2 weeks, and 3 weeks using the House-Brackmann facial nerve grading system. Results Compared to before treatment, the House-Brackmann grades of both EW and E groups after 1, 2 and 3 weeks of treatment significantly decreased (p<0.05). Regarding group comparison, the House-Brackmann grade of the EW group was significantly lower than the E group at 1 week (p=0.043), but there was no significant difference at 2 and 3 weeks. Regarding improvement of House-Brackmann grades, there was no significant difference between the two groups at 1, 2 and 3 weeks (p>0.05). Conclusions Compared to just acupuncture treatment, collaborative treatment with prednisolone significantly improved the House-Brackmann grade after 1 week, but there was no difference as time passed. Because early intervention determines the prognosis of Bell's palsy, collaborative treatment at the early stage will be clinically helpful to patients.

The Effects of Virtual Upper Extremity Training Using the RAPAEL Smart Glove on Physical and Cognitive Function in Stroke Survivors -A Single Group Study-

  • Song, Chiang-Soon;Lim, Jae-Heon;Jeon, Byeong-Hyeon;Lee, Hye-Sun
    • PNF and Movement
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    • v.17 no.2
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    • pp.199-206
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    • 2019
  • Purpose: The purpose of this study was to evaluate the effects of a virtual upper extremity training program using the RAPAEL Smart Glove on upper extremity function in stroke survivors with chronic hemiparesis and to focus the training program development using the Smart Glove as a feasibility study. Methods: This study was conducted using a single group and pre-post test research design in the outpatient departments of local rehabilitation units. Ten chronic hemiparetic stroke survivors with a diagnosis of first stroke received therapeutic rehabilitation at the rehabilitation units. All the participants used a virtual reality program with the RAPAEL Smart Glove for 30 minutes per session 3 days a week over 8 weeks. They also received conventional occupational therapy with functional electrical stimulation for 40 minutes per session 3 days a week for 8 weeks as an additional therapy. To analyze the effects of this therapeutic intervention, four clinical measures, including the box-block test (BBT), the Wolf motor function test (WMFT), the trail-making score, the Jebsen Taylor hand function test (JTHFT), and grip strength, were used. Results: Upon completion of the intervention in week 8, all the participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to the respective baselines at week 0. Conclusion: This study suggests that virtual upper extremity training using the RAPAEL Smart Glove has a reasonable and beneficial effects on upper extremity function in chronic hemiparetic stroke survivors.

Inequality in Private Health Care Expenditures: A 36-Year Trend Study of Iranian Households

  • Aghapour, Ehsan;Basakha, Mehdi;Kamal, Seyed Hossein Mohaqeqi;Pourreza, Abolghasem
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.4
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    • pp.379-388
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    • 2022
  • Objectives: Throughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households. Methods: This study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP. Results: Average Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively. Conclusions: In this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

Role of Exercise after Subacromial Bursa Injection in Subacromial Subdeltoid Bursitis (견봉하 삼각근하낭염 환자에서 견봉하낭 스테로이드 주사 후 운동의 효과)

  • Kim, Sunwoong;Kim, Sang Jun
    • Clinical Pain
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    • v.16 no.1
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    • pp.20-25
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    • 2017
  • Objective: To find that the patients who conducted home self-exercise in conjunction with intra-articular corticosteroid injection will have better improvement in subacromial subdeltoid (SASD) bursitis symptoms than those who received only an injection. Method: A prospective, nonrandomized, comparison study was conducted in outpatient rehabilitation clinic in a tertiary university hospital. Patients diagnosed with SASD bursitis with physical examination and ultrasound evaluation were included and received ultrasound guided injection (UGI). Patients were divided into two groups according to the compliance of self-exercise: UGI-exercise group and UGI only group. Visual analog scale (VAS) was checked before, at 3 weeks, 3 months, and 6 months after the UGI. A patient's global impression of change (PGIC) survey was made at 3 months after the UGI. Results: A total of 82 patients with SASD bursitis were included. At 3 weeks after the injection, the mean VAS for the UGI-exercise group was 2.6 ± 1.7 and for UGI only group was 1.9 ± 1.3 (p=0.030). At 3 months after the injection, the mean VAS for the UGI-exercise group was 4.0 ± 1.3 and for UGI only group was 5.4 ± 1.4 (p<0.001). Conclusion: We concluded that home-based self-exercise of the shoulder provides an additional benefit for pain alleviation possibly with prolonging the effect of injection in SASD bursitis.

A Case Study of Polyarthritis Treated with Dokhwaljihwang-tang (독활지황탕으로 호전된 다발성 관절염 환자 치험 1례)

  • Lee, Jae-Wook;Choi, Hyun-Min;Lim, Eun-Chul
    • Journal of Sasang Constitutional Medicine
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    • v.29 no.4
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    • pp.369-375
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    • 2017
  • Objectives The purpose of this study is to report a case of improving various symptoms such as polyarthritis, dyspnea, fatigue, heat sensation. In addition, the promising explanation on the perspective of the heat and cold syndrome could be elicited. Methods Dokhwaljihwang-tang was prescribed for an outpatient for 3 weeks without any other therapy such as acupuncture, moxibustion and Western medicine. To evaluate the results of this treatment, polyarthritis was assessed by Visual Analogue Scale(VAS). The patient's general condition such as digestion and defecation discomfort is assessed by the progress notes. Results&Conclusions Most of the various symptoms have improved by about 80 percent. It is more important to observe defecation, urine, cold symptoms and condition of hands and feet synthetically.

Ultrasound Guided Nerve Block at Vertebra and Lower Extremity (초음파를 활용한 하지와 체간부위의 신경차단술)

  • Park, Hyeng-Kyu
    • Clinical Pain
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    • v.20 no.2
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    • pp.93-98
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    • 2021
  • The use of ultrasonography has recently been increasing in musculoskeletal diagnosis or intervention treatment. Ultrasound guided procedure offers a reliable alternative to fluoroscopy or computed tomography for lumbar medial branch block, facet joint block and peripheral nerves of lower extremity. Further, there is no exposure to radiation and additional equipment necessary for the protection against radiation is required. And ultrasound guided procedure needs smaller space than fluoroscopy guided procedure with real time images in the outpatient department. This article reviews ultrasound guided procedure at lumbar vertebra and peripheral nerves of lower extremity.