• Title/Summary/Keyword: Pain of Lower Extremities

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Immediate Effects of Appling Resistance in the Bridge Exercise on Muscle Activity in the Trunk and Lower Extremities

  • Sun Min Kim;Gku Bin Oh;Gang Mi Youn;Ji Hyun Kim;Ki Hun Cho
    • Journal of Korean Physical Therapy Science
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    • v.30 no.3
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    • pp.1-13
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    • 2023
  • Background: The bridge exercise prevents repeated damage to the tissues around the spine by reducing stimulus transmission to the ligaments and joint capsules, thereby alleviating back pain. It also contributes to strengthening the muscles of the lower extremities. Design: A Single Subject experience design. Methods: This study was conducted on 28 healthy adults in their 20s to 30s and conducted at St. Mary's Hospital in C City from May to July 2021. Four types of bridge exercise were performed in this study: the normal bridge exercise and bridge exercises with 0.5%, 1%, or 1.5% body weight resistance applied on the pelvis through manual resistance during the bridge exercise and to determine the effect of resistance applied in the bridge exercise on the activation of the trunk and lower extremities muscles. Results:This study showed that the muscle activity of the trunk and lower extremities improved significantly in response to stronger resistance when manual resistance equivalent to 0.5%, 1%, or 1.5% of body weight was applied during the bridge exercise compared to when the normal bridge exercise was performed. Conclusion: This study shows that manual resistance can be applied as an effective method of bridge exercise since muscle activity in the trunk and lower extremities increases when manual resistance causing isometric contraction is applied.

Postoperative Pain Management Status led by Nurse of Acute Pain Service (급성통증관리 간호사 주도의 수술 후 통증관리 현황)

  • Kang, Mi Ra;Ryu, Jeong Ok;Kim, Myung Hee;Yun, Hea Shin;Kwon, Jeong Soon
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.296-304
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    • 2020
  • Purpose: This study was conducted to demonstrate objective stability of postoperative pain management status managed by nurse-based, anesthesiologist-supervised Acute Pain Service (APS). Methods: A retrospective descriptive review was conducted with 5,748 patients who had used intravenous Patient Controlled Analgesia (PCA) from January to December 2017. Data were analyzed using descriptive statics, Frequency analysis, ANOVA, Cross tabulation with χ2test, and Correlation coefficient. Results: As the APS nurse's education date increased, the period of using PCA was statistically significantly longer, and the period of stopping PCA while using it became shorter (p<.001). Statistically significant, the most painful operations were extremities, spine, upper abdomen, and thorax, while the least painful surgery was lower abdomen (p<.001). Lower abdominal surgery used the highest amount of PCA (p<.001), and extremities and spinal surgery, the lowest amount of PCA and frequently stop using it (p<.001). The most common side effects were nausea and vomiting after surgery, with an incidence of 16.0% within 24 hours and 9.8% within 48 hours. The overall error caused by PCA was 1.5%, with 84.3% being caused by human errors. Conclusion: With the pain management effect of APS nurses, patients used PCA more effectively. There were also fewer side effects and error rates compared to prior studies. Therefore, it is suggested that this system is safe and effective for pain management.

Ultrasound Guided Low Approach Interscalene Brachial Plexus Block for Upper Limb Surgery

  • Park, Sun Kyung;Sung, Min Ha;Suh, Hae Jin;Choi, Yun Suk
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.18-22
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    • 2016
  • Background: The interscalene brachial plexus block is widely used for pain control and anesthetic purposes during shoulder arthroscopic surgeries and surgeries of the upper extremities. However, it is known that interscalene brachial plexus block is not appropriate for upper limb surgeries because it does not affect the lower trunk (C8-T1, ulnar nerve) of the brachial plexus. Methods: A low approach, ultrasound-guided interscalene brachial plexus block (LISB) was performed on twenty-eight patients undergoing surgery of the upper extremities. The patients were assessed five minutes and fifteen minutes after the block for the degree of block in each nerve and muscle as well as for any complications. Results: At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be $2.8{\pm}2.6$ and $1.1{\pm}1.8$, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 26 of the 28 patients (92.8%), and in all of the other three nerves in all 28 patients. None of the patients received additional analgesics, and none experienced complications. Conclusions: The present study confirmed the achievement of an appropriate sensory and motor block in the upper extremities, including the ulnar nerve, fifteen minutes after LISB, with no complications.

Induction of Pain in the Ipsilateral Lower Limb from Long-term Cane Usage after Stroke (만성 뇌졸중 환자에서 장기간 지팡이 사용이 건측 하지 통증 발현에 미치는 영향)

  • Son, Sung-Min;Kwon, Jung-Won;Nam, Seok-Hyun;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.25 no.1
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    • pp.36-41
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    • 2013
  • Purpose: To investigate whether the long-term use of a cane induces pain in the unaffected lower limb of stroke patients. Methods: A total of 107 stroke patients with chronic hemiparesis were recruited in this study and classified into two groups; a cane-use group (n=49) and non-cane-use group (n=58). The existence of pain in the unaffected lower limb was assessed on a visual analog scale in the hip, knee, and ankle joint, and the University of Alabama pain behaviors scale (UAB pain behavior scale) used to measure the intensity of pain. In addition, the Motricity Index (MI) was tested in the upper and lower extremities. Results: The proportion of pain in each joint of the lower limb was significantly higher in the cane-use group, compared to the non-cane-use group (p<0.05). In addition, significant differences were observed on the UAB pain behavior scale between the two groups. The lower MI score was significantly lower in the cane-use group, compared with the control group. However, no difference was observed in MI scores of the upper limb between the two groups. Conclusion: These findings reveal that long-term cane usage can induce pain in the unaffected lower limb of stroke patients. We suggest careful consideration when prescribing a cane, depending on functional ability in hemiparetic patients, and recommend continuous evaluation for pain in the affected lower limb.

The Effects of Kyongrak Massage in the Elderly with Chronic Pain (경락마사지가 만성 통증 노인에게 미치는 효과)

  • Jun, Jum-Yi
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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    • pp.155-164
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    • 2001
  • Purpose: this study was implemented to develop new nursing intervention, Kyongrak massage, and to examine its effect on chronic pain in elderly women. Method: Kyongrak massage is a manipulation massaging on Kyonghyul site, and Duboo, Kyongchoo, Chucksoo, Hajee, Sangjee Kyongrak massages were used in this study. The subjects(11persons) took Kyongrak massage on head, neck, spinal cord, upper extremities and back lower extremities for 25minutes daily during 5days. The dependent variables were subjective health state, paid, blood pressure, pulse and body temperature. This study was carried out, at 10-12 o'clock, from August 7th, to 22th, 2000. Data were analyzed using frequency, percentage, mean, standard deviation, paired t-test by SPSS PC. Results: subjective health state((t=-3.560, p=.005), body temperature(t=-2.557, p=.029) were increased, and pain level(t=7.884, p=0.000), systolic blood pressure(t=2.923, p=.015) were decreased significantly by Kyongrak massage. Conclusions: The above results have informed us that this Kyongrak massage program(Duboo, Kyongchoo, Chucksoo, Hajee, sangjee) for 25minutes is a useful nursing intervention to decrease chronic pain in each life styles.

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Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

  • Lee, Dae Wook;Lim, Chang Hun;Han, Jae Young;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.274-276
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    • 2016
  • Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

Paraplegia Caused by Vertebral Metastasis during Pain Control in Cervical Cancer Patient -A case report- (자궁경부암 환자의 통증치료중 척추전이에 의한 하반신 마비 -증례 보고-)

  • Kim, In-Jung;Chun, Bum-Soo;Kyeon, Il-Soo;Lee, Jung-Koo
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.304-307
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    • 1997
  • Continuous epidural infusion, a combination of local anesthetic and opioid, have been widely administered for treatment of chronic cancer pain. A serious complications of epidural block is paraplegia which can also be caused by : direct spinal cord injury, epidural hematoma, epidural abscess, ischemic change, neurotoxicity, preexisting disease. Continuous epidural block for pain control of patient with cervical cancer was performed at $T_{12}/L_1$ interspace. A 4 cm catheter was inserted cephalad into the epidural space. After four months, back pain and motor weariless of lower extremities progressively developed. Spine CT showed bony destruction and soft mass-like lesion at $T_9$ & $T_{12}$ spine. We propose paraplegia was caused by spinal cord compression which resulted from vertebral metastasis of cervical cancer.

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Prolotherapy for the Lower Extremities (하지에서의 프롤로 치료)

  • Kim, Yong Uck
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.1
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    • pp.37-44
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    • 2009
  • Prolotherapy, the technology for strengthening lax ligaments, has found increased acceptance in recent years. Prolotherapy involves the injection of the irritant solutions into the weakened or stretched ligaments which are a source of chronic pain. This induces an inflammatory response which mimics the normal repair sequence. Various musculoskeletal disorders of lower extremities such as degenerative arthrtitis, ligament and tendon injuries can be treated with prolotherapy. Prolotherapy is a very good, powerful nonsurgical conservative treatment in various musculoskeletal disorders. Ultrasound exam is very useful to find and confirm the exact location of disorders and check the progress in prolotherapy practices.

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Diagnosis and Endovascular Treatment of May-Thurner Syndrome (May-Thurner 증후군의 진단과 혈관내 치료)

  • 허균;이재욱;신화균;원용순
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.911-917
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    • 2004
  • Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

The Effects of a Functional Movement Screen on Pain and Performance Ability in Professional Fencing Players (펜싱선수에서 통증과 수행 능력이 기능적 동작 검사에 미치는 영향)

  • Kim, Seong-Yeol;Lee, Je-Hoon;An, Seung-Heon
    • The Journal of Korean Physical Therapy
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    • v.23 no.1
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    • pp.21-28
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    • 2011
  • Purpose: The aim of this study was to investigate correlations between the Functional Movement Screen (FMS), pain, and performance ability in professional fencing players. Methods: Fifty-six athletes participated in this study. The pain group included those who had a score on a pain-related Visual Analogue Scale (VAS) of ${\geq}$20 and an Oswestry Disability Index (ODI) score ${\geq}$10). In the non-pain group, these scores were: VAS(<20), ODI(<10). The VAS and ODI were used to measure pain throughout the study. Performance ability included motor function of the lower extremities (as assessed by a Modified Functional Index Questionnaire, MFIQ), dynamic balance (Balance system, BS and Posture med, PM), flexor and extensor muscle strength of the lumbar region was recorded as maximal isometric strength. Results: Among athletes who had pain, 5 of 15(33.33%) showed impaired functional movement. Conversely, only 2 of 41(4.88%) of those who had no pain showed such impairment (FMS ${\leq}$14score). The athletes who had pain and who had an FMS score above 14 (10/56; 17.86%) showed a significantly higher score for extensor muscle strength of the lumbar compared with those with pain and an FMS score below 14 (5/56; 8.93%) were significant correlations between the FMS and pain (r=-0.40 to -0.42, p<0.01), the MFIQ (r=-0.33, p<0.05), dynamic balance (r=-0.27 to -0.40, p<0.05-0.01), muscle strength of the lumbar (r=0.27 to 0.29, p<0.05). Stepwise multiple regression analysis showed that the dynamic balance score (${\beta}{\beta}$=-0.41) had slightly more power in predicting FMS score than pain, motor function of lower extremity, or muscle strength. Conclusion: The FMS was significantly associated with values of pain, motor function of the lower extremities, dynamic balance, and muscle strength of the lumbar. However the FMS appears to lack relevance and reasonable evidence to suggest that it is an acceptable measurement tool for functional movement analysis.