• Title/Summary/Keyword: Pain of lower extremity

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Effect on Balance Ability of Knee Osteoarthritis by Lower Extremity Patterns with dynamic reverse in Proprioceptive Neuromuscular Facilitation (PNF 하지 패턴 중 동적반전(dynamic reverse) 기법이 퇴행성 슬관절염 환자의 균형능력에 미치는 영향)

  • Jung, Hyun-Sung;Jeon, Ho-Young;Bae, Sung-Soo
    • PNF and Movement
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    • v.4 no.1
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    • pp.27-36
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    • 2006
  • Purpose : The main purpose of this study was to investigate the effect on Balance Ability of Knee Osteoarthritis(OA) by Lower Extremity Patterns with dynamic reverse in Proprioceptive Neuromuscular Facilitation(PNF). Methods : The subjects were consisted of 30 women patients with knee OA. All subjects were randomly assigned to PNF group. Each group had a treatment for 30 minutes per day and three times a week during 8 weeks period. Was used to measure recovery or worse of patient's condition, muscle assessment questionnaire(MAQ) was used to measure patient' s muscular strength, Endurance, coordination/balance, KWOMAC was used to pain, stiffness, and physical function, and BPM was used to measure path, anterior-posterior. Results : This study results in following conclusons. 1. MAQ score was significantly decreased in PNF group(p<.05). 2. KWOMAC score was significantly decreased in PNF group(p<.05). 3. BPM were score was significantly decreased in PNF group(p>.05). Conclusion : From this result the PNF treatment retrogression characteristic will be effective in treatment of patient, with the arthritis and widely may be applied at a therapist.

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Effectiveness of continuous hypertonic saline infusion with an automated infusion pump for decompressive neuroplasty: a randomized clinical trial

  • Lee, Ho-Jin;Lee, Jaewoo;Park, Yeon wook;Gil, Ho Young;Choi, Eunjoo;Nahm, Francis Sahngun;Lee, Pyung Bok
    • The Korean Journal of Pain
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    • v.32 no.3
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    • pp.196-205
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    • 2019
  • Background: Hypertonic saline (HS) injections for decompressive neuroplasty (DN) can cause pain. We assessed whether a continuous infusion of HS through an infusion pump would reduce injection-related pain compared with repeated bolus administrations. Methods: Fifty patients scheduled for DN were randomized to either the bolus injection or the continuous infusion group. After appropriately placing the epidural catheter, 4 mL of 5% NaCl was injected as four boluses of 1 mL each at 15-minute intervals or infused over 1 hour using an infusion pump. The severity of pain induced by HS injection, as measured by the 11-point numerical rating scale (NRS), was the primary outcome. The severity of low back or lower extremity pain, as measured by the 11-point NRS and Oswestry Disability Index (ODI), 3 months following the procedure, was the secondary outcome. Results: Data from 21 patients in the bolus group and 23 in the continuous infusion group were analyzed. No statistically significant difference in injection-related pain was identified between the two groups during the initial HS administration (P = 0.846). However, there was a statistically significant reduction in injection-related pain in the continuous infusion group compared to the bolus injection group from the second assessment onwards (P = 0.001, < 0.001, and < 0.001, respectively). No significant between-group differences in the NRS and ODI scores 3 months post-procedure were noted (P = 0.614 and 0.949, respectively). Conclusions: Our study suggests that administering HS through a continuous infusion is a useful modality for reducing HS injection-related pain during DN.

Post-thoracotomy pain control with paravertebral intercostal nerve block (개흉술후 벽측흉막외 신경차단법에 의한 진통효과)

  • Im, Chang-Yeong;Kim, Yo-Han
    • Journal of Chest Surgery
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    • v.26 no.10
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    • pp.781-786
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    • 1993
  • Effrctive analgesia after elective thoracotomy can be provided by continuous extrapleural intercostal nerve block.This study was designed to prove the effectiveness of continuous extrapleural intercostal nerve block. Twenty patients undergoing elective thoracotomy were randomized into two groups. Group I received lumbar epidural block[N=10] and group II received continuous extrapleural intercostal nerve block[N=10]. Postoperative pain relief was assessed on Numeric Rating Scale[NRS] and recovery of pulmonary function was assessed by coparison of preoperatrive and postoperative FVC[Forced Vital Capacity], FEV1[Forced expiratory Volume in 1 second], VC[Vital Capacity]. Arterial blood gas analysis[ABGA], vital signs and amount of additive analgesics were compared also. No significant difference was observed between the groups concerning these parameters mentioned above. Systemic complications, such as urinary retention[2/10] and weakness of lower extremity[2/10], occurred in group I but no complication occurred in group II. We conclude that continuous extrapleural intercostal nerve block is as effective as epidural block in pain relief and restoration of pulmonary mechanics with fewer comlications. Also because of it`s ease and safetiness, this must be considered as a substitute of epidural block in routine use for thoracotomy pain relief.

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Successful removal of permanent spinal cord stimulators in patients with complex regional pain syndrome after complete relief of pain

  • Lee, Su Jung;Yoo, Yeong Min;You, Jun A;Shin, Sang Wook;Kim, Tae Kyun;Abdi, Salahadin;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.47-50
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    • 2019
  • Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

The Shoulder Pain after Stroke and the relationship with Motor Function, and Quality of Life (뇌졸중 환자의 견관절 통증과 운동 기능 및 삶의 만족도와의 관계)

  • Lee, Dong-Jin;An, Seung-Heon
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.3
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    • pp.257-266
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    • 2011
  • Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

Implantable Intrathecal Drug Delivery Pump in Complex Regional Pain Syndrome Patient -A case report- (복합부위통증증후군 환자에게 시행한 매몰식 펌프를 이용한 지주막하강 내 약물투입 -증례보고-)

  • Seo, Kyung Soo;Han, Kyung Ream;Kim, Sae Young;Park, Kyeong Eon;Kim, Chan
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.74-77
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    • 2009
  • Implantable intrathecal pump is one of the therapeutic options for intractable pain. A 24-year-old male with complex regional pain syndrome was suffering from right lower extremity pain. He had all modalities of treatment including spinal cord stimulator. However, his pain had been worse in the past 6 months. His visual analogue pain scale (VAS) was 8-10 and he could not sit or walk. Only opioid was thought to be effective. Then, intrathecal pump was considered. We estimated the minimal effective dose of spinal morphine before implantation. 0.3 mg of morphine was injected intrathecally as a starting dose. Dosage had been increased up to 0.8 mg in 10 days. His VAS score decreased from 8 to 5. He could sleep without pain and walk with crutch. Therefore, intrathecal pump was inserted. He could tolerate to pain. This case suggests that intrathecal morphine delivery can provide effective treatment for intractable non-malignant pain.

A Case Study on Effect of Oriental Medical Treatment to an Aged Female Obese Patient (한방비만치료의 여성노인환자 치험1례)

  • Kim, Eu-Gene;Cha, Yun-Yeop;Kim, Dong-Gun;Heo, Seong-Kyu;Heo, Young-Jin;Han, Seok-Hun;Kong, In-Pyo
    • Journal of Korean Medicine for Obesity Research
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    • v.7 no.1
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    • pp.87-96
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    • 2007
  • Objectives : This study was performed to evaluate the effect of oriental medical treatment on aged female obese patient. Methods : We experienced an aged female obese patient. We applied herbal medication(Choweseuncheng-tang), electrolipolysis, auricular acupuncture to her from 26th, March. 2007 to 25th, May. 2007. And we examined the changes of her weight, body composition, body size, skin resistance variability, visual analogue scale of knee pain. Results : 1. Her weight decreased from 73.5kg to 71.1kg and body mass index(BMI) decreased from $29.46kg/m^2$ to $28.11kg/m^2$. 2. Body fat mass(BFM) decreased from 25.7kg to 21.6kg but body muscle mass(BMM) increased from 45.1kg to 46.7kg. 3. Waist-hip ratio(WHR) decreased from 0.96 to 0.92. 4. Basal metabolic rate(BMR) increased from 1,273kcal to 1,314kcal. 5. The circumference of upper extremity decreased 1.03cm and lower extremity decreased 1.30cm but the circumference of the muscle of upper extremity increased 0.41cm and lower extremity increased 0.63cm. 6. The circumference of chest and hip are decreased. In addition to the circumference and fat of abdomen are decreased. 7. The visual analogue scale of knee pain is improved. Conclusions : According to above results, oriental medical treatment could be used safety to aged obese patients without loss of fat free mass. The study is more required to aged obese patient from now on.

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A Case of Combination of Korean Medicine Treatments in Neurogenic Claudication and Lower Extremity Weakness due to Spinal Stenosis (척추관 협착으로 인한 신경원성 파행 및 하지 근력 저하에 대한 한방복합치료 치험 1례)

  • Choi, Ki-hoon;Kim, Tae-ju;Choi, Ki-won;Heo, Seung-jin;Kwon, Oh-hoon;Kim, Kwang-hwi;Kim, Tae-yeon;Lee, Tae-geol;Choi, Kang-eah
    • The Journal of Internal Korean Medicine
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    • v.40 no.2
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    • pp.165-172
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    • 2019
  • Background: To suggest potential of Korean medicine treatments as a conservative management for neurogenic claudication and lower extremity weakness due to spinal stenosis. Case Summary: The patient suffered weakness, pain and numbness of the right leg and difficulty walking with diagnosis of spinal stenosis due to herniated lumbar intervertebral disc. Korean medicine treatments, including herbal medicine, acupuncture, pharmacopuncture and Chuna manual therapy were applied. The Numeric Rating Scale (NRS) of pain and numbness in the right leg decreased from 7 to 4, with an increase in strength of the right leg from 60% to 95% compared to the strength of left leg. Walking duration also increased from less than one minute to more than five minutes. Conclusion: Korean medicine treatment may be considered as an effective conservative management for symptoms of spinal stenosis.

The Effect of Stretching and Pre-eccentric exercise on Delayed Onset Muscle Soreness (스트레칭과 사전원심성 운동이 지연성근육통에 미치는 영향)

  • Jeong, Jin-Gyu;Ryu, Seong-Sun;Kim, Yong-Nam;Kang, Jong-Ho;Kim, Su-Hyun;Hwang, Tae-Yeon
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.15-22
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    • 2010
  • Purpose : This study examines the effects of pre-eccentric exercise and stretch ing to bicepsbrachii to prevent delayed onset muscle soreness and recovery of muscular function depending on the training intensity with 28 normal adults in their twenties. Methods : The subjects were divided into a control group, a group without any previous eccentric exercise, and a stretching group. Pre-eccentric exercise group conducted exercise with the intensity of 25% of maximal voluntary contraction. Pre-eccentric exercise and stretching was applied before to induce delayed onset muscle soreness and after, 24 hour post, 48 hour post, and 72 hour post. Measurements were conducted to examine pain and muscular function changes before, immediately after, and after inducing delayed onset muscle soreness. After inducing delayed onset muscle soreness, measurements were taken at the 24th hour, 48th hour, and 72nd hour. Results : The pre-eccentric exercise group and stretching group showed a significant difference from the control group by isometric contract ion power and mechanical pain threshold as a result of measuring delayed onset muscle soreness. Conclusion : From these results, electrical stimulation using presynaptic inhibition mechanism of transcutaneous electrical stimulation (TES) had positive effects for walking ability on inhibition of muscle tone in lower extremity. The motor level stimulation group experienced a more significant effect than the sensory level stimulation group. Therefore, the transcutaneous electrical stimulation (TES) is considered to be effective on walking ability increasing through inhibition of muscle tone in lower extremity for rehabilitation of post stroke hemiplegic patients.

Effects of Korean Medicine Based Arthritis Management Program on Joint Function, Physical Fitness and Self-Care of the Elderly Women with Osteoarthritis. (한의약 관절염관리프로그램이 골관절염 여성노인의 관절기능, 체력 및 자가관리수행에 미치는 효과)

  • Kim, Young-Hee;Park, Kum-Sook;Jeong, Heon-Young
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.2
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    • pp.105-116
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    • 2017
  • Objectives : The purpose of this study was to investigate the effects of Korean medicine based arthritis management program for community dwelling elderly women with osteoarthritis. Methods : A Nonequivalent control group pretest-posttest design was used for this study. Elderly people who agreed to participated in the study were assigned to a experimental group(n = 29) or a control group (n = 30). The Korean medicine based arthritis management program conducted for 12 weeks, 2 times a week. Study outcomes were measured by structured questionnaires from April, 2016 to July. For data analysis, independent t-test, Mann-Whitney U test and ANCOVA were performed using SPSS version 21.0. Results : Pain, stiffness, balance, strength of lower extremity, and self care activity were significant difference between the two groups in pretest and posttest(F = 8.23, p = 006), (F = 9.13, p = .004), (F = 5.74, p = .020), (F = 4.98, p = .030), (F = 8.47, p = .005). Conclusions : The Korean medicine based arthritis management program was effective on decreasing joint pain, stiffness, and increasing balance, strength of lower extremity and self care activity of community dwelling elderly women with osteoarthritis. This program was found to be useful in alleviating and managing joint symptoms of elderly women with osteoarthritis.