• Title/Summary/Keyword: Range of motion(ROM)

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Effect of The Daoyin Exercise Therapy Combined with Complex Korean Medicine Treatment on Pain and Function Improvement of Low Back Pain Patients : A Retrospective Observational Study (한방복합치료를 병행한 도인운동요법이 요통환자의 통증 및 기능 개선에 미치는 영향 : 후향적 관찰 연구)

  • Choi, Bong Seok;Lee, Eun Jung;Li, Yu Chen;Lee, Jung Min;Kim, Eun Seok;Song, Gwang Chan;Jung, In Chul;Oh, Min Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.1
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    • pp.88-97
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    • 2018
  • This study was designed to prove the effect of the Daoyin exercise therapy combined with complex korean medicine treatment on pain and function improvement of low back pain patients. A retrospective observational study. 30 low back pain patients, checked numeric rating scale(NRS) over 5, were treated with the Daoyin exercise therapy combined with complex korean medicine treatment. NRS, roland & morris disability questionnaire(RMDQ), range of motion(ROM), isokinetic muscle strength, and euroqol five demension questionnaire(EQ-5D) were checked to evaluate patients. The Daoyin exercise therapy combined with complex korean medicine treatment reduced NRS $5.67{\pm}1.40$ to $3.73{\pm}1.72$, improved RMDQ $10.33{\pm}4.91$ to $8.17{\pm}5.40$, strengthened lumbar muscle's peak torque and improved EQ-5D $0.56{\pm}0.20$ to $0.63{\pm}0.15$ and euroqol visual analogue scale(EQVAS) $46.80{\pm}19.95$ to $57.50{\pm}19.93$ but had no effect on ROM. NRS decreased significantly as the number of trials increased. No one had serious adverse reactions. As described above, the Daoyin exercise therapy combined with complex korean medicine treatment can help reducing low back pain, improving lumbar function, strengthening lumbar muscle power and stamina and improving quality of life of low back pain patients.

Biomechanical Analysis of a Combined Interspinous Spacer with a Posterior Lumbar Fusion with Pedicle Screws (척추경나사못을 이용한 유합술과 동반 시술된 극돌기간 삽입기구의 생체역학적 연구)

  • Kim, Y.H.;Park, E.Y.;Lee, S.J.
    • Journal of Biomedical Engineering Research
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    • v.36 no.6
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    • pp.276-282
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    • 2015
  • Recently, during the multi-level fusion with pedicle screws, interspinous spacer are sometimes substituted for the most superior level of the fusion in an attempt to reduce the number of fusion level and likelihood of degeneration process at the adjacent level. In this study, a finite element (FE) study was performed to assess biomechanical efficacies of the interspinous spacer combined with posterior lumbar fusion with a previously-validated 3-dimensional FE model of the intact lumbar spine (L1-S1). The post-operative models were made by modifying the intact model to simulate the implantation of interspinous spacer and pedicle screws at the L3-4 and L4-5. Four different configurations of the post-op model were considered: (1) a normal spinal model; (2) Type 1, one-level fusion using posterior pedicle screws at the L4-5; (3) Type 2, two-level (L3-5) fusion; (4) Type 3, Type 1 plus Coflex$^{TM}$ at the L3-4. hybrid protocol (intact: 10 Nm) with a compressive follower load of 400N were used to flex, extend, axially rotate and laterally bend the FE model. As compared to the intact model, Type 2 showed the greatest increase in Range of motion (ROM) at the adjacent level (L2-3), followed Type 3, and Type 1 depending on the loading type. At L3-4, ROM of Type 2 was reduced by 34~56% regardless of loading mode, as compared to decrease of 55% in Type 3 only in extension. In case of normal bone strength model (Type 3_Normal), PVMS at the process and the pedicle remained less than 20% of their yield strengths regardless of loading, except in extension (about 35%). However, for the osteoporotic model (Type 3_Osteoporotic), it reached up to 56% in extension indicating increased susceptibility to fracture. This study suggested that substitution of the superior level fusion with the interspinous spacer in multi-level fusion may be able to offer similar biomechanical outcome and stability while reducing likelihood of adjacent level degeneration.

Effects of Korean Medicinal Treatments Including Antaeeum-gamibang on Posterior Neck Pain and Lower Back Pain Caused by Traffic Accidents During Pregnancy: Five Case Reports (안태음(安胎飮) 가미방(加味方)과 한방치료를 병행한 임신 중 교통사고로 인한 경추 및 요추부 통증 환자 치험 5례)

  • Shin, Soo-Ji;Kim, Gil-Hwan;Ju, Yeong-Guk;Lee, So-Jin;Ahn, Sang-Min;Jeong, Jae-Joong
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.3
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    • pp.146-157
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    • 2017
  • Objectives: This study was performed to assess the effectiveness of Korean medicinal treatments including Antaeeum-gamibang on posterior neck pain and lower back pain caused by traffic accidents during pregnancy. Methods: Patients were treated by Antaeeum-gamibang, acupuncture and Chuna manual therapy. To measure treatment outcomes, Numerical rating scale (NRS), Oswestry disability index (ODI), Neck disability index (NDI), European Quality of Life-5 Dimensions (EQ-5d), and range of motion (ROM) were used. Results: After treatment, the average NRS of posterior neck pain significantly decreased from $4.20{\pm}1.30$ to $1.80{\pm}0.45$ and the average NRS of lower back pain significantly decreased from $6.40{\pm}1.14$ to $2.20{\pm}0.84$. ODI significantly decreased from $41.42{\pm}17.79$ to $28.29{\pm}14.69$, NDI significantly decreased from $34.93{\pm}9.85$ to $20.27{\pm}8.96$. EQ-5d and ROM improved at all cases. Conclusions: Korean Medicinal treatments including Antaeeum-gamibang may be effective in the treatment of posterior neck pain and lower back pain caused by traffic accidents during pregnancy. However, more case reports and studies are required to identify exactly what treatment is more efficient.

Short-term Low-dose Oral Corticosteroid Therapy of Impingement Syndrome of the Shoulder: A Comparison of the Clinical Outcomes to Intra-articular Corticosteroid Injection

  • Kim, Young Bok;Kim, Young Chang;Kim, Ji Wan;Lee, Sang Jin;Lee, Sang Won;Choi, Hong Joon;Lee, Dong Hyun;Kim, Joo Young
    • Clinics in Shoulder and Elbow
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    • v.17 no.2
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    • pp.50-56
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    • 2014
  • Background: To assess the clinical outcomes of short-term oral corticosteroid therapy for impingement syndrome of the shoulder and determine whether it can be substituted as an alternative to the intra-articular injection. Methods: The clinical outcomes of the 173 patients, the oral steroid group (n=88) and the injection group (n=85), were measured at 3 weeks, 2, 4, and 6 months postoperatively. The clinical outcomes were assessed by measuring the the University of California at Los Angeles (UCLA) score, visual analog scale (VAS) and range of motion (ROM) at every follow-up. Any complications and recurrence rate were noted. A relationship between the treatment outcomes and factors such as demographic factors, clinical symptoms and radiographic findings were determined. Results: No difference was observed in VAS and UCLA scores between the two groups, but forward flexion and internal rotation of ROM were significantly improved in the injection group at the 2nd and 4th postoperative month (p < 0.05). At 6th postoperative month, recurrence rate of symptoms was 26% in the oral steroid group and 22% in the injection group. No major adverse effects were observed. When the clinical outcomes of the oral steroid group were compared to either demographic, clinical symptoms, or radiographic findings, UCLA score was found to be significantly low (p < 0.05) in patients with joint stiffness and UCLA score, whereas VAS score was significantly improved in patients with night pain (p < 0.05). Conclusions: Short-term low-dose oral corticosteroid therapy of impingement syndrome showed comparable clinical outcomes to intra-articular injection without any remarkable adverse effects. Low-dose oral steroids can be regarded as a partial alternative to intra-articular injection for the initial therapy of impingement syndrome of the shoulder.

Arthroscopically Assisted Repair of Large to Massive Rotator Cuff Tears -The Role of Acromioplasty- (중범위 이상 회전근 개 파열 환자의 관절경적 봉합술 -견봉성형술의 역할-)

  • Lee, Kwang-Won;Kim, Kap-Jung;Lee, Hang-Ho;Kim, Byung-Sung;Kim, Ha-Yong;Choi, Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.143-148
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    • 2003
  • Objectives: To analyze the postoperative functional outcome of shoulder in patients with arthroscopically assisted repair of large to massive rotator cuff tears with or without acromioplasty and role of acromioplasty. Materials and Methods: From June 1996 to June 2002, twenty six patients with large to massive rotator cuff tears were undergone arthroscopically assisted repair. Mean follow up was over one year. Fourteen were male and twelve were female. Mean age was 51 years old(39-66). Mean duration was 9 months. Acromioplasty was done in 14 cases concomitantly. They were divided into two groups. Group I: arthroscopic cuff repair with acromioplasty(14 cases). Group II: arthroscopic cuff repair without acromioplasty(12 cases). Each shoulder was evaluated at preoperative and final follow-up with Visual Analogue Scale(VAS), University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASES standardized shoulder assessment form, Simple Shoulder Test, UCLA score and range of motion(ROM). We analyzed the differences between the two groups. Shoulder ROM and acromioplasty were determining factors. Statistics was tested by correlation analysis and repeated measure ANOVA test. Results: At the final follow up, functional outcome and pain were improved but they had no statistical significance between the two groups(p>0.05). Combined procedure, acromioplasty, didn't affect on VAS. UCLA score, University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASf:S standardized shoulder assessment form and Simple Shoulder Test(p>0.05). In group II, forward flexion and abduction were statistically improved at the final follow up than in group I(p<0.05). Conclusions: It appears that arthroscopic repair is satisfactory procedure in patients with large to massive cuff tears. Combined procedure, acromioplasty, doesn't affect on postoperative functional outcome of shoulder.

Demineralized Bone Matrix (DBM) as a Bone Void Filler in Lumbar Interbody Fusion : A Prospective Pilot Study of Simultaneous DBM and Autologous Bone Grafts

  • Kim, Bum-Joon;Kim, Se-Hoon;Lee, Haebin;Lee, Seung-Hwan;Kim, Won-Hyung;Jin, Sung-Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.225-231
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    • 2017
  • Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

Outcomes of Arthroscopic Assisted Reduction and Percutaneous Fixation for Tongue-Type Sanders Type II Calcaneal Fractures (설상형 Sanders 제 II형 종골 골절에 대한 관절경하의 정복 및 경피적 고정술의 결과)

  • Park, Jae Woo;Park, Chul Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.144-150
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    • 2017
  • Purpose: To assess the clinical and radiographic results and complications of arthroscopy-assisted reduction and percutaneous fixation for patients with tongue-type Sanders type II calcaneal fractures. Materials and Methods: Between August 2014 and December 2015, 10 patients who underwent surgery using subtalar arthroscopic assisted reduction and percutaneous fixation for tongue-type Sanders type II calcaneal fractures were reviewed. The mean age was 50.8 years (36~62 years), and the mean follow-up period was 24 months (12~40 months). The clinical results were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at the regular follow-ups, and the foot function index (FFI) at the last follow-up. The subtalar range of motion (ROM) was evaluated and compared with the uninjured limb at the last follow-up. The radiographic results were assessed using the Bohler's angle from the plain radiographs and the reduction of the posterior calcaneal facet using computed tomography (CT). The postoperative complications were assessed by a chart review. Results: The VAS and AOFAS ankle-hindfoot score improved until 12 months after surgery. The FFI was 15 (1.8~25.9) and subtalar ROM was 75.5% (60%~100%) compared to the uninjured limb at the last follow-up. The $B{\ddot{o}}hler^{\prime}s$ angle was increased significantly from $2^{\circ}$ ($-14^{\circ}{\sim}18^{\circ}$) preoperatively to $21.8^{\circ}$ ($20^{\circ}{\sim}28^{\circ}$) at the last follow-up. The reduction of the posterior facet was graded as excellent in five feet (50.0%) and good in five (50.0%) on CT obtained at 12 months after surgery. One foot (10.0%) had subfibular pain due to a prominent screw head. One foot (10.0%) had pain due to a longitudinal tear of the peroneal tendon that occurred during screw insertion. Conclusion: Subtalar arthroscopic-assisted reduction of the posterior calcaneal facet of the subtalar joint and percutaneous fixation is a useful surgical method for tongue-type Sanders type II calcaneal fractures.

The Action-observation Training Impacts on the Improvement of Stroke Patient's Cognitive Functioning (동작관찰훈련이 뇌졸중 환자의 인지기능 향상에 미치는 영향)

  • Lee, Seul-Ah;Kang, Seon-Hwa;Choi, Won-Ho;Lee, In-Kyung;Jung, Sang-Mi
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.1
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    • pp.199-206
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    • 2019
  • This study aims to identify whether the action-observation training impacts on the improvement of stroke patient's cognitive functioning. When it comes to the research methods, Korean version of Mini-Mental State Examination (MMSE-K) and Literacy Independent Cognitive Assessment (LICA) conducted to assess samples between 23 April and 18 May 2018. Samples are seven patients who are hospitalized in Kyung-In region. In the meantime, seven tasks such as the range of joint motion (ROM) dance, arrangement of pullover clothes, lacing-ups of a pair, folding up a facecloth and socks, the origami and tying a necktie implemented as the action-observation programme. In order to analyse collected data, descriptive statistics analysis, paired t-test and the Wilcoxon signed-rank test were carried out via SPSS version 20 (a statistics programme). The change in value from MMSE-K showed its statistical significant as 3.29 (±1.38, p<.001) as well as value from LICA in recollective powers was 12.16 (±6.73), therefore, the statistic is said to be statistically significant. In conclusion, action-observation training most influenced recollective powers amongst stroke patient's cognitive functioning areas. Even though development of cognitive functioning discovered in other areas, its values were possibly statistically insignificant. Hence, future research ought to demonstrate which areas action-observation training is effective according to brain lesion site.

Effects of Physical Therapy Combined with Virtual Reality Games on Pain, Function, Quality of Life, And Engagement in Post-Knee-Surgery Patients (가상현실 게임을 적용한 물리치료가 무릎 수술 후 환자의 통증, 기능 변화, 삶의 질, 동기부여에 미치는 영향)

  • Hong-Gil Kim;Ju-Hyeon Jung
    • PNF and Movement
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    • v.21 no.3
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    • pp.345-356
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    • 2023
  • Purpose: The aim of this study was to investigate the effects of physical therapy combined with a virtual reality (VR) game on pain, quality of life (QOL), engagement, and knee function in post-knee-surgery patients. Methods: Twenty-four patients who had undergone knee surgery four weeks or more before the study were recruited. Two withdrew from the study during the four-week experimental period, and a total of 22 patients were included in the final analysis. Routine physical therapy consisting of electrostimulation (10 min.) and therapeutic massage (10 min.) was the base intervention for all groups. The experimental group (n = 10) was additionally exposed to a VR game intervention, while the control group (n = 12) underwent an intervention involving similar motions as the experimental intervention but with no VR. The intervention for the experimental group used the game Rig Fit Adventure on Nintendo switch. Both groups underwent their respective interventions 3 times a week (35 min. per session) for 4 weeks. Pain was assessed using the numeric rating scale (NRS), and QOL was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L). Engagement was assessed using the Korea flow state scale (K-FSS). Finally, knee movement and function were assessed based on knee flexion and extension, range of motion (ROM), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Results: After the four-week physical therapy, both groups showed significant reductions in pain (on the NRS), increased knee ROM (flexion), better WOMAC scores, and increased EQ-5D-5L scores (p < 0.05), with the experimental group showing significantly better improvements in EQ-5D-5L and K-FSS scores (p < 0.05). Conclusion: The results of this study confirm that a VR-game-integrated intervention is effective for improving pain, QOL, engagement, and knee function in post-knee surgery patients and that VR-game-integrated interventions could be therapeutic alternatives for patients bedridden for prolonged periods with little motivation for rehabilitation.

The Comparison of Low Intensity Eccentric Exercise and Dynamic Stretching on Delayed Onset Muscle Soreness (저강도 원심성 운동과 동적 스트레칭이 지연성 근육통에 미치는 효과 비교)

  • Lee, Su-Young;Kim, Ji-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.10
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    • pp.4676-4685
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    • 2012
  • We investigated to compare the effects of a low intensity eccentric exercise and dynamic stretching on symptoms of delayed onset muscle soreness (DOMS). The eighteen women who had not participated in a regular exercise programme for the lower extremities in the previous five months were randomly assigned to one of three experimental groups: control group, a low intensity eccentric exercise group and dynamic stretching group. We measured the joint range of motion (ROM), maximal voluntary isometric exercise (MVIC), muscle soreness rating scale and ultrasound image measurement before eccentric exercise inducing DOMS, and 24, 48, and 72 hours after an eccentric exercise inducing DOMS. The exercise programme in a low intensity eccentric exercise group and dynamic stretching group were respectively performed 3 times a week for 4 weeks before eccentric exercise inducing DOMS. There was significantly different between the groups in muscle soreness rating scale and MVIC (p<.05). However, there was not significantly different between groups in ultrasound image measurement and ROM (p<.05). These results suggest that a low intensity eccentric exercise group and dynamic stretching group effectively reduced muscle soreness rating scale out of the symptoms of DOMS. A low intensity eccentric exercise group may be an effective improvement than dynamic stretching group in muscle soreness rating scale.