• 제목/요약/키워드: Range of motion(ROM)

검색결과 668건 처리시간 0.027초

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

  • 이광원;김갑중;이항호;김병성;김하용;최원식
    • Clinics in Shoulder and Elbow
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    • 제6권2호
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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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    • 제60권2호
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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.

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

  • 박재우;박철현
    • 대한족부족관절학회지
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    • 제21권4호
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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.

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

  • 이슬아;강선화;최원호;이인경;정상미
    • 한국엔터테인먼트산업학회논문지
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    • 제13권1호
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    • pp.199-206
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    • 2019
  • 연구목적은 동작관찰훈련이 뇌졸중 환자의 인지기능 향상에 영향을 미치는가를 알아보고자 하였다. 연구방법으로는 2018년 4월 23일부터 5월 18일까지 경인지역 병원에 입원 중인 재활환자 7명을 대상으로 MMSE-K와 LICA를 사용하여 평가를 진행하였고, 동작관찰프로그램으로는 상지 ROM 댄스, 풀 오버형 옷정리, 운동화 끈 묶기, 수건 개기, 양말 개기, 종이접기, 넥타이 매는 법 총 7가지 과제를 적용하였다. 통계프로그램으로는 SPSS version 20을 사용하였으며 기술통계, Wilcoxon signed ranks을 사용하여 값을 구하였다. 동작관찰훈련을 적용한 결과 MMSE-K 점수는 3.29±1.38의 변화량을 보여 p값 0.001로 유의한 값을 보였고, LICA 점수는 기억력에서 12.16±6.73으로 가장 유의한 값이 나왔다. 결론은 동작관찰훈련이 뇌졸중 환자의 인지기능 영역 중 기억력에서 가장 많은 영향을 미쳤으며, 다른 영역에서도 점수 향상은 있었으나 통계적으로 유의하지는 않았다. 앞으로 동작관찰훈련이 많이 사용되어 추후에는 뇌손상 부위별로 어느 영역에서 효과가 있는지에 대한 후속 연구가 이루어지길 바란다.

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

  • 김홍길;정주현
    • PNF and Movement
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    • 제21권3호
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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.

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

  • 이수영;김지윤
    • 한국산학기술학회논문지
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    • 제13권10호
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    • pp.4676-4685
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    • 2012
  • 본 연구는 저강도 원심성 운동과 동적 스트레칭이 지연성 근육통에 미치는 효과를 비교하고자 시행하였다. 본 연구의 대상자는 연구에 참여하기 5개월 전부터 하지에 규칙적인 운동을 하지 않았던 18명의 20대 건강한 여성을 대상으로 하였다. 대상자들은 전체 3그룹인 대조군, 저강도 원심성 운동군 그리고 동적 스트레칭군에 무작위로 배정되었다. 측정변수로는 최대 수의적 등척성 수축력, 초음파 영상을 통한 근 두께, 근 통증 척도, 무릎관절 가동범위이며 지연성 근육통 유발 전, 유발 후 24시간, 48시간, 72시간에 각각 측정되었다. 저강도 원심성 운동군과 동적 스트레칭군의 운동 프로그램은 지연성 근육통 유발 4주 전에 일주일에 3회씩 각각 시행되었다. 본 연구의 결과 최대 수의적 등척성 수축력과 근 통증 척도에서만 그룹간 유의한 차이가 있었으며(p<.05), 저강도 원심성 운동은 동적 스트레칭에 비해 근 통증 척도가 유의하게 감소하였다(p<.05). 그러므로 저강도 원심성 운동과 동적 스트레칭이 지연성 근육통의 증상 중 근 통증에 효과적임을 제시하며 또한 저강도 원심성 운동이 동적 스트레칭보다 근 통증을 빠르게 감소시킴으로써 근 통증에 더 효과적임을 제시하고자 한다.

트레드밀 내리막 보행을 이용한 노인 낙상관련 위험요인의 운동역학적 분석 (Biomechanical Analysis of Elderly Fall Related Risk Factors using Downhill Walking on Treadmill)

  • 우정현;박상균
    • 한국체육학회지인문사회과학편
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    • 제55권2호
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    • pp.643-655
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    • 2016
  • 본 연구는 내리막 경사의 변화에 따른 노인집단과 젊은 성인집단의 운동역학적 보행분석을 통해, 두 집단 간 보행패턴의 차이를 비교 분석하여 노인들의 운동역학적 측면에서 낙상 요소를 파악하는데 목적이 있다. 20대 건강한 젊은 성인여성집단(yrs: 21.17±1.5)과 65세 이상의 건강한 노인여성집단(yrs: 66.67±1.33)을 대상으로 각각 18명씩 실험 참여자로 선정하였으며 트레드밀 위에서 선호속도로 평지, -7.5°, -15°의 세 가지의 경사조건에서 보행을 실시하였다. 노인집단은 성인집단에 비해 내리막 보행 시 신체중심의 좌우변위가 더 큰 것으로 나타났고(p<.05), 경사에 따라 무릎과 발목 관절의 발목 가동변위는 노인집단이 더 작은 것으로 나타났다(p<.05). 엉덩관절의 가동범위에서는 집단 간 차이가 나지 않았지만 노인집단의 최대 신전 각은 성인집단보다 작은 것으로 나타났다(p<.05). 또한, 내리막 보행 시, 성인집단보다 더 적은 무릎 신전모멘트가 작용한 것으로 나타났다(p<.05). 본 연구 결과 노인들은 내리막 보행 시 낙상 위험에 더욱 노출되고 불안정한 보행을 할 것이라는 예상과 달리 젊은 성인집단보다 더욱 안정적인 보행 전략을 세워서 걷는 것으로 나타났다. 본 연구를 통해 노인들의 보행특성 및 낙상과 관련된 운동역학적 변인을 수집하고, 노인의 낙상을 예방하기 위한 후속연구의 기초자료로서 도움을 줄 것이라 예상된다.

U-12 유소년 축구선수의 운동수행력 및 의학적 평가 (Evolution of Exercise Performance and Medical Assessments in U-12 Youth Football Players)

  • 서상원;이호성
    • 한국체육학회지인문사회과학편
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    • 제56권5호
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    • pp.665-677
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    • 2017
  • 이 연구는 U-12 유소년 축구선수를 대상으로 운동수행력과 의학적 평가를 상세히 분석한 후에 축구를 통한 운동수행력의 변화 및 의학적 문제점을 파악하는데 그 목적이 있다. 연구대상은 유소년 축구클럽에 참여하고 있는 초등학교 선수를 유소년 축구선수 집단(Youth football players group; YFG, n=15; $11.2{\pm}0.9$ 세)과 축구를 하지 않는 건강한 일반 유소년을 통제 집단(Control group; CON, n=15; $11.5{\pm}0.6$ 세)으로 각각 분류하여 운동수행력(건강관련 체력, 운동관련 체력, 기능적 움직임 및 동적 균형) 및 의학적 평가(하지정렬, 관절가동범위 및 도수근력검사)를 측정하였다. 왕복 오래달리기, 50-m 달리기, 눈 감고 외발서기, 능동적 하지직거상, 회전 안정성 및 비주측의 종합점수는 CON과 비교해서 YFG에서 긍정적인 결과를 보였다. 하지만, 하지정렬에서 주측 및 비주측의 Q각, 관절가동범위에서 비주측의 발목관절 발등굽힘, 주측 및 비주측의 발목관절 발바닥굽힘, 도수근력검사에서 주측의 엉덩관절 폄 및 벌림, 무릎관절 굽힘 및 폄, 비주측의 무릎관절 굽힘 및 폄은 CON과 비교해서 YFG에서 부정적인 결과를 초래하였다. 따라서 이 연구에서 U-12 유소년 축구선수는 부분적으로 운동수행력은 우수하게 나타났지만, 의학적 평가에서는 부정적인 결과를 확인하였다.

동결견의 한의학적 치료에 대한 국내 연구 동향 (The Domestic Trends of Traditional Korean Medicine Treatments on Frozen Shoulder)

  • 손슬기;김종수;김신웅;문병헌;유수빈;이차로
    • 척추신경추나의학회지
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    • 제9권1호
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    • pp.55-65
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    • 2014
  • Objectives : The purpose of this review is to investigate the trends of traditional korean medicine treatments on frozen shoulder. Methods : We investigated the studies on traditional korean medicine treatments for frozen shoulder via searching 6 Korean web databases. As a result, 32 research papers were found to be analyzed according to their published year, the titles of journals, published institution, the types of study, the number of cases, the types of treatments, the instruments for assessment and ethical approvals. Results : 32 papers were published since 1989. The studies on traditional korean medicine treatments about frozen shoulder were mainly published in The journal of korean acupuncture & moxibustion medicine. 10 case series, 7 reviews, 6 non-randomized controlled trials, 5 randomized controlled trials and 4 case reports had been under research. In most of the research, the number of the cases were not enough. In 15 cases of the studies, various traditional korean medicine treatments were used to treat the symptoms. In 8 cases of the studies, one method was used to treat the symptoms. Range of motion(ROM) and visual analogue scale(VAS) were used as primary assessments. Among the 25 clinical studies, 5 of them were accepted by institutional review board(IRB). Conclusion : In this study, we analyzed the trends of traditional korean medicine treatments on frozen shoulder. Reviewing the domestic trends of studies on traditional korean medicine treatments for frozen shoulder and examining the strong and weak points of those treatments are essential for the future studies.

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주관절 외측상과염의 침치료에 대한 국내 연구 동향 분석 (The Domestic Trends of Acupuncture Treatment on Lateral Epicondylitis : A literature review)

  • 김현석;이치호;오민석
    • 혜화의학회지
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    • 제25권1호
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    • pp.1-13
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    • 2016
  • Objectives : Lateral epicondylitis on elbow is one of the most common causes of elbow pain. Lateral epicondylitis can be managed with acupuncture, but the evidence for its effectiveness is uncertain. The purpose of this review is to investigate the trends of acupuncture treatments on lateral epicondylitis. Methods : We investigated the studies about acupuncture treatments for lateral epicondylitis via searching 5 Korean web databases(KTKP, RISS, OASIS, KCI, Kisti) The key search terms were 'Lateral epicondylitis', 'Tennis elbow', 'External epicondylitis'. 12 research papers(10 case reports, 1 RCT, 1NRCT) were found to be analyzed according to their published year, the titles of journals, published institution, the types of study, the number of cases, the types of treatments, the instruments for assessment and ethical approvals. The effectiveness of acupuncture treatment was classified. Results : 12 papers were published since 2003. The studies on acupuncture treatments about lateral epicondylitis were mainly published in The journal of pharmacopuncture. 10 case reports, 1 non-randomized controlled trials, 1 randomized controlled trials had been under research. In most of the research, the number of the cases were not enough. In 9 cases of the studies, various korean medicine treatments including acupuncture were used to treat the symptoms. In 3 cases of the studies single method was used to treat the symptoms. Visual analogue scale(VAS) and range of motion(ROM), grip strength were used as primary assessments. Among 12 clinical studies, 1 of them were accepted by institutional review board(IRB). Conclusions : In this study, we analyzed the trends of acupuncture treatments on lateral epicondylitis. Reviewing the domestic trends of studies on acupuncture treatments for lateral epicondylitis and examining the strong and weak points of those treatments are essential for the future studies.