• Title/Summary/Keyword: Progressive Intervention

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Surgical Roles for Spinal Involvement of Hematological Malignancies

  • Kim, Sang-Il;Kim, Young-Hoon;Ha, Kee-Yong;Lee, Jae-Won;Lee, Jin-Woo
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.534-539
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    • 2017
  • Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

Effect of Progressive Resistance Task-oriented Strengthening Exercise on Balance and Activities of Daily Living in Stroke Patients (점진적 과제지향적 다리근력강화 운동이 뇌졸중 환자의 균형능력과 일상생활수행능력에 미치는 영향)

  • Kang, Tae-Woo;Kim, Hye-Mi;Kim, Beom-Ryong
    • PNF and Movement
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    • v.18 no.1
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    • pp.77-86
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    • 2020
  • Purpose: This study investigated the effects of progressive resistance task-oriented strengthening exercises (PRTSE) on the strength of the lower extremities, balance, and activities of daily living (ADL) of patients following a stroke. The purpose of the study was to provide fundamental data regarding the use of PRTSE with stroke patients. Methods: Twenty stroke patients were randomly divided into an experimental group (n = 10) who took part in PRTSE and a control group (n = 10) who performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes five times a week for four weeks. The strength of their lower extremities was measured using a hand-held dynamometer. The balance of the participants was assessed using a Berg balance scale. The modified Barthel index was conducted to measure ADL. A paired t-test was performed to compare within-group changes before and after the PRTSE. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: After the exercises, there was a significant within-group change in the strength of lower extremities, balance, and ADL in the experimental group and the control group (p < 0.05). There was also a significant between-group difference in the strength of lower extremities after the intervention (p < 0.05). Conclusion: General rehabilitation is commonly applied as a treatment for stroke patients and is relatively effective. The application of PRTSE may be useful in such patients, considering its effects on the strength of lower extremities, balance, and ADL.

Development of Family Support Physical Activity Program for the Male Elderly with Sarcopenia based on Social Cognitive Theory (사회인지이론을 적용한 근감소증 남성 노인의 가족지지기반 신체활동증진프로그램 개발)

  • Choi, Hyun-a;Park, Kyung-Min;Moon, Kyoung-ja
    • Journal of East-West Nursing Research
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    • v.26 no.1
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    • pp.39-51
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    • 2020
  • Purpose: The purpose of this study was to develop family support oriented physical activity program for the male elderly with sarcopenia based on social cognitive theory. Methods: This program was developed through an analysis of 18 related intervention literatures, results of a focus group interview with 5 elderly men with sarcopenia and the content validity index of the program content adequacy and applicability by 6 experts. The combined exercise with resistance exercise and aerobic exercise was constructed in accordance with the recommendations of the American College of Sports Medicine (ACSM) and experts' opinions. Results: The program consists group education sessions (5 times, 60 minutes for each) for 12 weeks and family support oriented physical activity program composed of individual intervention (sending alarm for physical activity for 10 times and telephone monitoring for 2 times). The program also reflects the concept of self-efficacy and self-regulation, which are important factors for continuing physical activity through family support. The progressive resistance exercise was developed by composing 5-6 systemic movement forms that repeat 2-3 days a week and 2-5 sets at least. Conclusion: It is proposed to standardize the family support oriented physical activity program through the further studies so that the program can be utilized for the various groups of people who need increased level of physical activities.

Development and Examination of the Online and Offline Educational Programs for Ankylosing Spondylitis Patients (강직성 척추염 환자의 오프라인 교육과 온라인 교육 프로그램 개발 및 효과 검증)

  • Lee, In-Ok;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.10 no.2
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    • pp.167-187
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    • 2003
  • Ankylosing spondylitis(AS) is one of the most common forms of chronic arthritis causing pain and progressive disability. The purposes of this study were 1) to develop an offline educational program and online educational program for the patients with ankylosing spondylitis; and 2) to test the effectiveness of each program in terms of changes in ankylosing spondylitis self-efficacy, exercise continuity disease activity, physical functioning, and depression. The convenient samples for three groups were selected acceding to the inclusion criteria. Online education group consists of 7 patients, and 14 patients were included for the offline group, while 12 patients were assigned to the control group. Outcomes variables included self efficacy, exercise continuity, disease activity, physical function, and depression and the reliability of each measure was ranged from .88 to .95 in the present study. The offline educational program demonstrated positive effects on self-efficacy, exercise continuity, disease activity, and depression, whereas the online educational program on exercise continuity, disease activity, and depression. The self-efficacy was showed positive effect only in the offline educational program, whereas physical functioning did not improve in both intervention groups. These partial improvements may be due to the small sample size and the methods of online education program. In conclusion, the effectiveness of the offline and online educational programs was partially supported in the present study. For the improvement of these programs, the further study would be necessary to apply this kind of intervention program with larger sample and to test the psychometric of the newly development tools.

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Effect of Visual Feedback Training for Gradual Weight Shift in the Sit-to-stand Training on the Balance and Walking Abilities of Chronic Hemiplegia Patients (앉고 일어서기 동작에서 점진적 체중 이동을 이용한 시각적 되먹임 훈련이 만성 편마비 환자의 균형 및 보행능력에 미치는 영향)

  • Kim, Kyung-hwan;Park, Sung-hoon;Kim, Hyung-min;Pak, Noh-wook;Kim, Da-yeon
    • PNF and Movement
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    • v.15 no.1
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    • pp.77-84
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    • 2017
  • Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.

Effect of Self-Complex Exercise Program on Pain, Function, Psychosocial, Balance Ability, and TrA Muscle in Patients with Lumbar Instability: A Randomized Controlled Trial (허리 불안정성이 있는 허리통증 환자에게 실시한 자가-복합 운동프로그램이 통증과 기능, 심리사회적, 균형 능력 그리고 배가로근에 미치는 효과)

  • Yoon, Jong-Hyuk;Jeong, Dae-Keun;Park, Sam-Ho
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.2
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    • pp.73-83
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    • 2022
  • Purpose : Low back pain (LBP) is reported as a risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. The lumbar spine in an unstable state causes imbalance and lumbar instability. Therefore, This study examined the effects of lumbar stabilization exercise and self-complex exercise program on pain, function, psychosocial level, static balance ability, and transverse abdominal muscle (TrA) thickness and contraction ratio in patients with lumbar instability. Methods : The design of this is a randomized controlled trial (RCT). Twenty-six LBP patients participated in this study. Screening tests were performed and assigned to the experimental group (n=13) and control group (n=13) using a random allocation program. Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the self-complex exercise program. All interventions were applied three times per week for four weeks. The quadruple visual analog (QVAS), the Korean version of the Oswestry disability index (K-ODI), Korean version of fear-avoidance belief questionnaire (FABQ), static balance ability, TrA thickness, and contraction ratio were compared to evaluate the effect on intervention. Statistical significance was set at 𝛼=.05. Results : Both groups showed significant differences before and after the intervention in QVAS, K-ODI, FABQ, static balance ability, and TrA thickness in contraction (p<.05). In addition, significant differences in K-ODI and FABQ were observed between the experimental group and control group (p<.05). Conclusion : A lumbar stabilization exercise and self-complex exercise program resulted in reduced dysfunctions, psychosocial stability in patients with lumbar instability. Therefore, Lumbar stabilization exercise and self-complex exercise program for patients with lumbar instability are effective method with clinical significance in improving the function and psychosocial stability.

Poly (ADP-ribose) in the pathogenesis of Parkinson's disease

  • Lee, Yunjong;Kang, Ho Chul;Lee, Byoung Dae;Lee, Yun-Il;Kim, Young Pil;Shin, Joo-Ho
    • BMB Reports
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    • v.47 no.8
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    • pp.424-432
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    • 2014
  • The defining feature of Parkinson's disease is a progressive and selective demise of dopaminergic neurons. A recent report on Parkinson's disease animal model demonstrates that poly (ADP-ribose) (PAR) dependent cell death, also named parthanatos, is accountable for selective dopaminergic neuronal loss. Parthanatos is a programmed necrotic cell death, characterized by PARP1 activation, apoptosis inducing factor (AIF) nuclear translocation, and large scale DNA fragmentation. Besides cell death regulation via interaction with AIF, PAR molecule mediates diverse cellular processes including genomic stability, cell division, transcription, epigenetic regulation, and stress granule formation. In this review, we will discuss the roles of PARP1 activation and PAR molecules in the pathological processes of Parkinson's disease. Potential interaction between PAR molecule and Parkinson's disease protein interactome are briefly introduced. Finally, we suggest promising points of therapeutic intervention in the pathological PAR signaling cascade to halt progression in Parkinson's disease.

Effects of Increasing Ankle Range of Motion Program on Ambulation and Balance for the Elderly With Balance Disorder (발목관절 가동범위 증진 프로그램이 노인의 보행과 균형능력 향상에 미치는 효과)

  • Lee, Sung-Eun
    • Physical Therapy Korea
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    • v.12 no.2
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    • pp.28-36
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    • 2005
  • The purpose of this study was to investigate the effects of the increasing ankle range motion program on ambulation and balance for the elderly with balance disorder. Eighteen elderly subjects were administered with a timed test twice; approximately 4 weeks apart. The exercise group participated in a fall prevention exercise class at the Y.S. Senior Welfare Center of the Seoul Metropolitan Government. The session consisted of a stationary cycle, static stretching ankle joints, balance boards, and progressive resistive exercises using the Thera-band. The results were as follows: Firstly, the increasing ankle range of motion program was effective on the exercise group. Gait-speed was improved (p<.005). Secondly, balance was significantly improved (p<.000). Thirdly, increasing ankle range of motion program was effective in ankle dorsiflexion which was the major risk factor for falls among the elderly. Differences in gait and balance between the groups were examined using a paired t-test (p<.05). The exercise group demonstrated significantly higher values of gait-speed, ankle range of motion, and balance when compared with the non-exercise group. The results of this study suggest that the increasing ankle range of motion program is an effective intervention for the elderly with balance disorder.

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Two Cases of Non-Small Cell Lung Cancer Treated with Intravenous Cultivated Wild Ginseng Pharmacopuncture (산삼약침 혈맥주입을 시행한 비소세포성폐암 환자 2례)

  • Bang, Sun-Hwi;Kwon, Ki-Rok;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.11 no.2
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    • pp.13-19
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    • 2008
  • Objectives To investigate the therapeutic effects of intravenous cultivated wild ginseng(Panax ginseng C.A. Meyer) pharmacopuncture(CWGP) in treating patients with non-small cell lung cancer(NSCLC). Design Prospective case series. Setting This study was conducted at the East-West Cancer Center of Dunsan Oriental Hospital, Daejeon University. Patients Two non-small cell lung cancer patients. Intervention Two non-small cell lung cancer patients were injected CWGP(20mL/day) mixed with 0.9% normal saline(100mL) intravenously. Each patient received a total of 16 and 9 cycles, respectively. One cycle is composed of 14 days. Outcome Measures The effect of intravenous CWGP was measured by scanning with computed tomography(CT) after every 2 cycle and Positron emission tomography- computed tomography(PET/CT) after every 6 cycles. Response and progression was evaluated using the Response Evaluation Criteria in Solid Tumors(RECIST) Committee classification of complete response(CR), partial response(PR), progressive disease(PD) and stable disease(SD). Results They were treated with intravenous CWGP for 8 and 5 months respectively. time later, each tumor remains stable disease(SD). Conclusion These cases may give us a possibility that intravenous CWGP offers potential benefits for non-small cell lung cancer patients.

OPTIC NERVE INJURY DUE TO FACIAL FRACTURES (안면골 골절로 인한 시신경 손상)

  • Yang, Young-Cheol;Ryu, Soo-Jang;Kim, Jong-Bae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.428-437
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    • 1994
  • Optic nerve injury serious enough to result in blindness had been reported to occur in 3% of facial fractures. When blindness is immediate and complete, the prognosis for even partial recovery is poor. Progressive or incomplete visual loss may be ameliorated either by large dosage of steroid or by emergency optic nerve decompression, depending on the mechanism of injury, the degree of trauma to the optic canal, and the period of time that elapses between injury and medical intervention. We often miss initial assessment of visual function in management of facial fracture patients due to loss of consciousness, periorbital swelling and emergency situations. Delayed treatment of injuried optic nerve cause permanent blindness due to irreversible change of optic nerve. But by treating posttraumatic optic nerve injuries aggressively, usable vision can preserved in a number of patients. The following report concerns three who suffered visual loss due to optic nerve injury with no improvement after steroid therapy and/or optic nerve decompression surgery.

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