• Title/Summary/Keyword: Spinal practice

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Reliability and validity of rasterstereography measurement for spinal alignment in healthy subjects

  • Yi, Yoon-Sil;Yoo, Seul-Ki;Lee, Da-Gam;Park, Dae-Sung
    • Physical Therapy Rehabilitation Science
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    • v.5 no.1
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    • pp.22-28
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    • 2016
  • Objective: The Back Mapper is one type of Rasterstereography and it can be used in the clinic without radiation exposure. The purpose of our study was to prove the reliability and validity of the Back Mapper and to compare it with the Spinal Mouse, which is an assessment tool for spinal curvatures using a wheeled mouse, and the Cobb angle by X-ray. Design: Cross-sectional study. Methods: Twenty healthy adults participated in the test to investigate for the inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with assessment devices for scoliosis such as the Back Mapper, Spinal Mouse and Cobb's angle. Data was analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement for reliability and correlation analysis for validity. Results: Intra-rater reliability of the Back Mapper was good (Cronbach's ${\alpha}$=0.821-0.984, ICC=0.696-0.969) except for assessing the lordotic angle. Inter-rater reliability was good (Cronbach's ${\alpha}$=0.870-0.958, ICC=0.770-0.919) in assessment for trunk imbalance, rotation of scapulae, thoracic angle, lumbar angle, and kyphotic angle. The kyphotic angle in the Spinal Mouse had a significant correlation icompared with the Back Mapper (r=0.510, p<0.05), and the Cobb's angle from an X-ray had a significant correlation with trunk inclination (r=0.532, p<0.05). Conclusions: These findings provide good intra-reliability of the Back Mapper in healthy subjects, but the Back Mapper requires more experienced practice to have good inter-reliability. Also, the variables of the Back Mapper does not seem as appropriate compared with the Cobb angle by X-ray.

Scoping Review of Ultrasonography in Assessing Manipulative Treatment for Spinal Diseases (척추 질환의 수기치료에서 진단용 초음파 활용을 위한 주제범위 문헌고찰)

  • Hyo-Eun Kim;Chang-Yeon Jung;Se-Jin Choi;Yeon-Woo Lee;Man-Suk Hwang
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.1
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    • pp.11-22
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    • 2024
  • Objectives This study aims to comprehensively review research utilizing ultrasonography for assessing manipulative treatment on spinal diseases, with the goal of promoting the wider integration of ultrasound imaging into clinical practice. Methods A systematic search was conducted on three international databases (Embase, PubMed, Cochrane) up to July 23, 2023. The search included key terms such as ultrasonography, manipulation, and skeletal muscle. The inclusion criteria narrowed down the selection to studies specifically related to lumbar and cervical vertebrae. Results Eleven studies were included in the review, with 10 focusing on lumbar vertebrae and one on cervical vertebrae, all employing spinal manipulation treatment. Among the 11 selected studies, nine primarily focused on ultrasound imaging to measure muscle thickness, while two utilized shear wave elastography to assess muscle stiffness. Also, rigorous measures were taken to ensure the reliability of the ultrasonography data. Conclusions This scoping review highlights the limited but growing evidence supporting the use of ultrasonography to assess manipulative treatment for spinal diseases. Despite a scarcity of studies in South Korea, it is crucial to recognize the potential of ultrasonography in becoming a widely used and practical tool for evaluating the effectiveness of manipulative treatments in the near future.

The Effectiveness of Meridian Acupressure Intervention Using Sticker Needles to Bowel Movement on Post Spinal Operative Patients (스티커 침을 이용한 경혈지압이 척추수술 후 배변에 미치는 영향)

  • Kim, Yang-Kuem;Lee, Hyang-Yeon
    • Journal of East-West Nursing Research
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    • v.11 no.1
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    • pp.33-41
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    • 2005
  • This study was conducted to identify the effect of meridian acupressure on defecation of patients with post spinal operation. The nonequivalent control group posttest only design was used. The data were obtained from 77 post spinal operative patients, 34 in the experimental 43 in control group in Y Hospital, Seoul, Korea. The neurosurgical unit A and B ward, assigned by matched sample by the name of operation such as laminectomy and posterior lumbar interbody fusion are performed. Meridian acupressure meant the method that an examiner presses response points distributed in the pass of energy vessel. In this study, meridian acupressure program was performed on as points in order of Hegue (LI-4), Zhigou (TE-6), Zusanli (S-36), Shangjuxu (S-37), Xiajuxu (S-39), Tianshu (S-25), Taichong (L-3) which was known to be related to large intestine. Data were collected from 1, July 2003 to 1, September 2003. Meridian acupressure program was carried out for 20 minutes 4 hours after operation twice daily. In order to evaluate the effect of meridian acupressure intervention, they were asked time of bowel recovery, gas passing, and defecation though questionnaire method. Data were analyzed by the SPSS/ WIN 11.0 program. The results of this study were summarized as follows; 1. Homogeneity tests of general characteristics and operation related characteristics of the experimental group and the control group were performed. General characteristics included age, sex, defecation habit, eating pattern, fluid intake, life style, activity, usage of laxative and etc. 2. Hypotheses were verification as follows; 1) Recovery of bowel sound of the experimental group who received meridian acupressure intervention was faster than that of the control group after spinal operation (t=-6.770,P=.000). 2) Time of gas passing of the experimental group who received meridian acupressure program was faster than that of the control group after spinal operation (t=-8.003, P=.000). 3) Time to defecation of the experimental group who received meridian acupressure program was faster than that of the control group after spinal operation (t=-9.026, P=.000). 4) Abdominal discomfort due to defecation of the experimental group who received meridian acupressure program was lesser than that of the control group after spinal operation (t=-3.431, P=.001). From these results, meridian acupressure intervention was effective for recovery of bowel sound, reduce time to gas passing, time to defecation and lessen abdominal discomfort due to defecation on post spinal operative patients. And therefore this intervention can probably considered on clinical practice.

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Study on the Movement of New Qi-gong "WuQinXi" Exercise for Lumbar Spinal Disease : Based on 10 Mode, 15 Mode, 18 Mode (요추 질환에 대한 신기공 오금희의 동작연구 -10식, 15식, 18식을 중심으로-)

  • You, Kyung Gon;Yeom, Seung Ryong;Lee, Sang Yeong;Kwon, Young Dal;Jeong, Hyun Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.3
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    • pp.280-288
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    • 2013
  • Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

Development of a Standardized Clinical Practice Education Program in Occupational Therapy Student (작업치료 대학생의 임상실습 교육 프로그램 개발)

  • Lee, Min-Jae;Lee, Sun-Min
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.27-38
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    • 2022
  • Purpose : This study is aimed to develop and validate the clinical practice education program and clinical competence scale of occupational therapy student. Methods : The development of the clinical practice education program used the delphi technique method, which had a total of five steps. Based on the occupational therapist's job analysis, the first stage assessed the importance of 21 experts, and the second stage examined the importance of 19 new specialists to derive constitutive factors. In the third stage, in-depth interviews were conducted with three experts based on the derived factors, and in the fourth stage, the final clinical practice education program was derived. In the final stage, the details of the clinical training program were drawn up based on the themes and were reviewed by two experts. Structured and unstructured interviews were conducted with 43 job experts. Results : The expert survey through the delphi technique was conducted three times, and content analysis and descriptive statistics were conducted to examine the distribution of responses. The final 11 educational program topics and contents were derived. Topics are confirmation of client information, evaluation and intervention, cognitive therapy, spinal cord injury, brain injury, musculoskeletal disorders, pediatric occupational therapy, interventions in activities of daily living, driving rehabilitation, vocational rehabilitation, occupational therapy assessment tool, safety training and management. Conclusion : The clinical practice education program reduce the difference between school education and clinical education of occupational therapy student. Occupational therapy helps college student understand occupational therapy practices and improve the quality of clinical education. Through more research and supplementation of clinical practice education programs in the future, it is suggested that clinical practice education be successfully operated in various practice institutions and used as basic data for designing and evaluating useful educational models.

Lumbar Facet Joint Injection: A Review of Efficacy and Safety (요추 후관절 주사: 임상적 유용성과 안전성에 대한 고찰)

  • Yoonah Do;Eugene Lee;Choong Guen Chee;Joon Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.54-76
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    • 2024
  • Facet joint arthrosis is a progressive degenerative disease that is frequently associated with other spinal degenerative disorders such as degenerative disc disease or spinal stenosis. Lumbar facet joint arthrosis can induce pain in the proximal lower extremities. However, symptoms and imaging findings of "facet joint syndrome" are not specific as they mimic the pain from herniated discs or nerve root compression. Currently, evidence for therapeutic intra-articular lumbar facet joint injections is still considered low, with a weak recommendation strength. Nevertheless, some studies have reported therapeutic effectiveness of facet joint injections. Moreover, the use of therapeutic facet joint injections in clinical practice has increased. This review article includes opinions based on the authors' experience with facet joint injections. This review primarily aimed to investigate the efficacy of lumbar facet joint injections and consider their associated safety aspects.

Effects of ASPAN's Evidence-based Clinical Practice Guidelines for Promotion of Hypothermia of Patients with Total Knee Replacement Arthroplasty (슬관절 전치환술 환자의 저체온 관리를 위한 ASPAN의 근거기반 임상실무 가이드라인 적용 효과)

  • Yoo, Je Bog;Park, Hyun Ju;Chae, Ji Yeoun;Lee, Eun Ju;Shin, Yoo Jung;Ko, Justin Sangwook;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.43 no.3
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    • pp.352-360
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    • 2013
  • Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

The Study of Total Body Modification (TBM) Technique System (Total Body Modification(TBM) 기법에 관한 고찰)

  • Shin, Byung-Cheul;Woo, Young-Min
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.61-71
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    • 2006
  • Objectives : To introduce Total Body Modification(TBM) technique system developed by Dr. Victor Frank DC, DO, ND through combining chiropractic manipulation with osteopathy, acupuncture meridian system, and naturopathy based on his long-time clinical experiences and insights. Methods : After investigating the art, philosophy and science of TBM thechnique, and applying TBM practice under private clinical situation, we compared It with Chuna Korean manual medicine and oriental medicine system. Results : This system deals with correcting human body's functional physiology to potentiate in a favorable manner. TBM uses a neuromuscular reflex test and body access meridian points to tap into the body's biocomputer and read functional programs. Corrections are usually made by means of special respiratory spinal adjustment, cranial, soft tissue, or specific joint manipulation. Conclusions : We found similarities between TBM and Chuna system in the view of Korean Traditional meridian concept. The special combinations and sequences of various alarm points and associated points have clinical effects on the treatment of chronic spinal subluxation pattern. This suggests TBM has significance In the point of the future evolution of Chuna manual medicine in Korea.

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Retethering : A Neurosurgical Viewpoint

  • Lee, Ji Yeoun;Kim, Kyung Hyun;Park, Kwanjin;Wang, Kyu-Chang
    • Journal of Korean Neurosurgical Society
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    • v.63 no.3
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    • pp.346-357
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    • 2020
  • During the follow-up period after surgery for spinal dysraphism, a certain portion of patients show neurological deterioration and its secondary phenomena, such as motor, sensory or sphincter changes, foot and spinal deformities, pain, and spasticity. These clinical manifestations are caused by tethering effects on the neural structures at the site of previous operation. The widespread recognition of retethering drew the attention of medical professionals of various specialties because of its incidence, which is not low when surveillance is adequate, and its progressive nature. This article reviews the literature on the incidence and timing of deterioration, predisposing factors for retethering, clinical manifestations, diagnosis, surgical treatment and its complications, clinical outcomes, prognostic factors after retethering surgery and preventive measures of retethering. Current practice and opinions of Seoul National University Children's Hospital team were added in some parts. The literature shows a wide range of data regarding the incidence, rate and degree of surgical complications and long-term outcomes. The method of prevention is still one of the main topics of this entity. Although alternatives such as spinal column shortening were introduced, re-untethering by conventional surgical methods remains the current main management tool. Re-untethering surgery is a much more difficult task than primary untethering surgery. Updated publications include strong skepticism on re-untethering surgery in a certain group of patients, though it is from a minority of research groups. For all of the abovementioned reasons, new information and ideas on the early diagnosis, treatment and prevention of retethering are critically necessary in this era.

Patient's Perception for Developing Research Questions of a Clinical Practice Guideline of Korean Medicine for Degenerative Lumbar Spinal Stenosis: A Descriptive Cross-Sectional Survey (퇴행성 요추 척추관 협착증의 한의표준임상진료지침 핵심질문 설정에 대한 환자 인식 설문 조사: 단면 설문 연구)

  • Choi, Seo Young;Bae, Ji Min;Choi, Ji Won;Yang, Gi Young;Lee, Byung Ryul;Kim, Kun Hyung
    • Korean Journal of Acupuncture
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    • v.35 no.3
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    • pp.130-138
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    • 2018
  • Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.