• Title/Summary/Keyword: Spinal practice

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Part 4. Clinical Practice Guideline for Surveillance and Imaging Studies of Trauma Patients in the Trauma Bay from the Korean Society of Traumatology

  • Chang, Sung Wook;Choi, Kang Kook;Kim, O Hyun;Kim, Maru;Lee, Gil Jae
    • Journal of Trauma and Injury
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    • v.33 no.4
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    • pp.207-218
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    • 2020
  • The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

A Comparative Study on the Concepts of the Chuna(推拿) (추나(推拿)의 개념 비교연구)

  • Park, Jong-Min;Shin, Sang-Woo;Park, Jong-Hyun
    • Journal of Korean Medical classics
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    • v.21 no.2
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    • pp.173-191
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    • 2008
  • The Chuna(推拿) in Korea has been developed since 1990's. Korean Chuna which is the only one manual therapy done by medical doctor is riched by absorbing other nation's manual therapy like Chinese Tuina(中國推拿) and Chiropractic therapy of U.S.A. So, We find that Korean Chuna's peculiarity and development by comparing Chinese Tuina, Chiropractic of U.S.A and Japanese manual therapy which influenced establishment of Korean Chuna. We compared each manual therapy's history, development, diagnosis, correction and treatment of human body, frequently contacting disease and medical service of the present state. Korean Chuna has absorbed other nation's manual therapy and advantage of preserving muscle-skeleton and spinal disorder disease. But, for more prosperity, it needs union of various conception and diagnosis and more research and application to more various disease, for example in internal medicine, gynecology or pediatry and founding system as regular academic work inside the college the possibility which objection and it will practice more completeness. And as one of specialty apprentice doctor subject inside the hospital, the possibility of raising a quality improvement of study and research environment.

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Two Cases of Disc Internal Disruption Syndrome (추간판 내부 파열 증후군(Internal disc disruption) 2례)

  • Lee, Jong-Hyeung;Ahn, Myun-Whan;Ahn, Jong-Chul
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.238-245
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    • 1991
  • The disc internal disruption syndrome is not well known to us, but the following hypothesis is widely accepted in clinical practice. The disc internal disruption syndrome may develop intractable back pain with aggrevated of pain, loss of spinal motion with any physical exercise, leg pain, loss of energy, marked weight loss, and profound depression. The patient with this syndrome will be found to have normal plain roentgenograms, myelograms, CT scans, results of blood examination and neurologic findings. For these reasons, this syndrome was frequently diagnosed by abnormal discographic findings. We had experience with two cases of disc internal disruption syndrome with clinical, roentgenographic and discographic evaluations. Thus We present these cases with a brief review of the concerned literature.

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Combined Korean Medicine Treatment of a Rare Case of Burst Fracture in an Elderly Patient with Kissing Spine

  • Park, Eun-Young;Choi, Jong-Ho;Jo, Hoo-In;Lee, Soo-Kyung;Lee, June-Haeng;Kang, Sun-Woo;Won, Yoon-Jae;Choi, Sung-Ryul;Cho, Yu-Jin
    • Journal of Acupuncture Research
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    • v.38 no.2
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    • pp.165-169
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    • 2021
  • A burst fracture refers to the fracture of the anterior and middle vertebral columns which are moving into the spinal canal causing neurological impairments, generally requiring surgical treatment. We herein report a rare case of burst fracture with kissing spine in a 90-year-old man who had severe lower back pain that worsened during back extension. Considering the surgical treatment risk, he was hospitalized at a Korean medicine hospital for 85 days and underwent combined Korean medicine treatments including pharmacopuncture, herbal medicine, chuna, deep-fascia meridian therapy, walking practice, and abdominal breathing. Based on patient-reported scales, his pain was alleviated, and his physical function improved. Furthermore, his range of motion and walking time increased. This case report suggests that combined Korean medicine treatments could be an effective alternative for patients with burst fracture who have surgery risks.

Effects of Therapeutic Exercise on Pain, Physical Function, and Magnetic Resonance Imaging Findings in a Patient with Multilevel Lumbar Disc Herniation: A Case Report

  • Kim, Ahram;Lee, Hoseong
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.1
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    • pp.1725-1733
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    • 2019
  • Background: In some clinical guidelines followed in clinical practice, nonsurgical treatments are recommended as the primary intervention for patients with lumbar disc herniation (LDH). However, the effect of a therapeutic exercise program based on stabilization of the lumbar spine for treatment of multilevel LDH has not been evaluated thoroughly. Objective: To investigate the effects of therapeutic exercise on pain, physical function, and magnetic resonance imaging (MRI) findings in a patient with multilevel LDH. Design: Case Report Methods: A 43-year-old female presented with low back pain, radicular pain and multilevel LDH (L3-L4, L4-L5, L5-S1). The therapeutic exercise program was conducted. in 40-min sessions, three times a week, for 12 weeks. Low back and radicular pain, lumbar disability, and physical function were measured before and after 6 and 12 weeks of the exercise program. MRI was performed before and after 12 weeks of the program. Results: After 6 and 12 weeks of the therapeutic exercise, low back and radicular pain and lumbar disability had decreased, and lumbar range of motion (ROM) was improved bilaterally, compared with the initial values. Also improved at 6 and 12 weeks were isometric lumbar strength and endurance, and the functional movement screen score. The size of disc herniations was decreased on MRI obtained after 12 weeks of therapeutic exercise than on the pre-exercise images. Conclusions: We observed that therapeutic exercise program improved spinal ROM, muscle strength, functional capacity, and size of disc herniation in LDH patient.

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

  • Park, Donghwi;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.200-205
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    • 2022
  • Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

Clinical application of Whidam's Su-Gi therapy to Low back pain (요통에 대한 휘담식 수기요법의 임상 적용)

  • Hun Mo Ahn;Sung Jin Chang;Han Joo Kang
    • Journal of Korean Medical Ki-Gong Academy
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    • v.21 no.1
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    • pp.13-21
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    • 2022
  • Objective : This report aimed to provide an introduction to the clinical application of Whidam's Su-Gi therapy to low back pain. Methods : Whidam's Su-Gi therapy for low back pain consisted of manual therapy according to upward and downward evaluations. Upward evaluation items include SLR, hip joint LOM, legs raising together, raising knee and turning left and right, and waist raising. Downward evaluation items include spinal alignment in sitting position, shoulder part tension, and cervical part tension. After performing the manual therapy according to the evaluation at each stage, the pain and dysfunction are reevaluated to confirm the negative and proceed to the next step. Conclusions : The clinical application of Whidam's Su-Gi therapy to low back pain is a method of interpreting and approaching low back pain disease with the theory of attraction pathology according to the principle of ChoGi-therapy(調氣療法).

Development of School Health Nursing Phenomena in Korea by Retrospective Method of ICNP (ICNP의 후향적 개발방법에 의한 한국의 학교간호현상)

  • Kim, Young-Im;Young, Soon-Ok;Wang, Myoung-Ja;Kim, Chung-Nam;Kim, Hyeon-Suk;Park, Tae-Nam;Chung, Mi-Ja;Hyun, Hye-Jin
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.595-607
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    • 2002
  • The objectives of this study were to identify the phenomena of school health nursing at schools in Korea and to contribute to building a school health domain of International Classification for Nursing Practice. A retrospective method was used in this study to develop ICNP during the period from July to October 200l. The procedure of the study involved choosing nursing phenomena using preliminary terms from the reports on the field of school health nursing practice documented by nursing students in 10 different nursing colleges. The detail procedures of the study were as follows. 1) Choosing nursing phenomena by using preliminary terms 2) Choosing the characteristics of school health nursing practice from the selected nursing phenomena 3) In order to make a consensus regarding the appropriate characteristics of phenomena. 15 study group members re-categorized the nursing phenomena through 5 times of cyber meetings and 3 times of formal meetings. 4) To verify each characteristic, 5 community nursing faculties and 25 school health nurses participated in the procedure to give scores on nursing characteristics. 5) Classification of the definite nursing phenomena and characteristics. Following the 5 step procedures, school health nursing phenomena were categorized into human and environmental domains. Human domains were classified into human behavioral and functional domains. Environmental domains were classified into physical and psychosocial domains. The essential characteristics of each phenomena were selected when it obtains the mean score of 3.0 or over at the related characteristics. The human behavioral domain consisted of 7 phenomena including risk for spinal disorder, inadequate dietary habit, inadequate weight control, smoking and substance abuse, inadequate stress management, inadequate sex related coping strategies and inadequate accident management. The human functional domain consisted of 6 phenomena including inadequate eye care and visual management, risk for respiratory disorder, inadequate dental health care, inappropriate infectious disease control, risk for gastrointestinal disorder, and lack of sexual identity. The physical environmental domain consisted of 6 phenomena including risk for incident at inside classroom, risk for incident at outside classroom, risk for incident around school, risk for exposure to hazardous facilities around school. inadequate garbage and disposal management, and inadequate physical environment for learning. The psychosocial domain included impaired social interaction at school. Each phenomenon was composed of 2 to 8 characteristics and all phenomena will include a total number of 85 characteristics. The phenomena of school health nursing in Korea partially confirmed school health architecture of ICNP. Further study on verification of school health nursing phenomena in Korea needs to be done to support the findings of this study through review of literature on nursing classifications or field studies.

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A Study on the Degree of Need of Human Structure and Function Knowledge in Clinical Nurses (기초간호자연과학의 인체구조와 기능 내용별 필요도에 대한 연구)

  • Choe, Myoung-Ae;Byun, Young-Soon;Seo, Young-Sook;Hwang, Ae-Ran;Kim, Hee-Seung;Hong, Hae-Sook;Park, Mi-Jung;Choi, Smi;Lee, Kyung-Sook;Seo, Wha-Sook;Shin, Gi-Soo
    • Journal of Korean Biological Nursing Science
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    • v.1 no.1
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    • pp.1-24
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    • 1999
  • The purpose of this study was to define the content of requisite human structure and function knowledge needed for clinical knowledge of nursing practice. Subjects of human structure and function were divided into 10 units, and each unit was further divided into 21 subunits, resulting in a total of 90 items. Contents of knowledge of human structure and function were constructed from syllabus of basic nursing subjects in 4 college of nursing, and textbooks published by nurse scholars prepared with basic nursing sciences. The degree of need of 90 items was measured with a 4 point scale. The subjects of this study were college graduated 136 nurses from seven university hospitals in Seoul and three university hospitals located in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, hospice ward, and their working period was mostly under 5 years. The results were as follows: 1. The highest scored items of human structure and function knowledge necessary for nursing practice were electrolyte balance, blood clotting mechanism and anticoagulation mechanism, hematopoietic function, body fluid balance, function of plasma, and anatomical terminology in the order of importance. The lowest scored items of human structure and function knowledge necessary for nursing practice was sexual factors of genetic mutation. 2. The highest order of need according to unit was membrane transport in the living unit, anatomical terminology in movement and exercise unit, mechanism of hormone function in regulation and integration unit, component and function of blood in oxygenation function unit, structure and function of digestive system in digestive and energy metabolism unit, temperature regulation in temperature regulation unit electrolyte balance in body fluid and electrolyte unit, concept of immunity in body resistance unit, and genetics terminology in genetics unit. The highest order of importance according to subunit was membrane transportation in cell subunit, classification of tissues in tissue unit, function of skin and skin in skin subunit, anatomical derivatives of the skeleton subunit, classification of joints in joint subunit, an effect of exercise on muscles in muscle subunit, function of brain in nervous system subunit, special sense in sensory subunit mechanism of hormone function in endocrine subunit, structure and function of female reproductive system in reproductive system unit, structure and function of blood in blood unit, structure of heart, electrical and mechanical function in cardiovascular system unit, structure of respiratory system in respiratory system subunit, structure and function of digestive system in digestive system subunit, hormonal regulation of metabolism in nutrition and metabolism subunit, function of kidney in urologic system subunit, electolyte balance in body fluid, electolyte and acid-base balance subunit. 3. The common content of human structure and function knowledge need for all clinical areas in nursing was structure and function of blood, hematopoietic function, function of plasm, coagulation mechanism and anticoagulation mechanism, body fluid, electrolyte balance, and acid-base balance. However, the degree of need of each human structure and function knowledge was different depending on clinical areas. 4. Significant differences in human structure and function knowledge necessary for nursing practice such as skin and derivatives of the skin, growth and development of bone, classification of joint, classification of muscle, structure of muscle, function of muscle, function of spinal cord, peripheral nerve, structure and function of pancrease, component and function of blood, function of plasma, structure and function of blood, hemodynamics, respiratory dynamics, gas transport, regulation of respiration, chemical digestion of foods, absorption of foods, characteristics of nutrients, metabolism and hormonal regulation, body energy balance were demonstrated according to the duration of work. 5. Significant differences in human structure and function knowledge necessary for nursing practice such as classification of tissue, classification of muscles, function of muscles, muscle metabolism, classification of skeletal muscles, classification of nervous system, neurotransmitters, mechanism of hormone function, pituitary and pituitary hormone, structure and function of male reproductive organ, structure and function of female reproductive organ, component and function of blood, function of plasma, coagulation mechanism and anticoagulation mechanism, gas exchange, gas transport, regulation of respiration, characteristics of nutrients, energy balance, function of kidney, concept of immunity, classification and function of immunity were shown according to the work area. Based on these findings, all the 90 items constructed by Korean Academic Society of Basic Nursing Science should be included as contents of human structure and function knowledge.

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Comparison of Trunk Strategy to Maintain Balance during the One-Leg Stance on a Medio-Lateral Ramp and an Anterior-Posterior Ramp

  • Lee, Sang-Yeol;Lee, Myoung-Hee
    • The Journal of Korean Physical Therapy
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    • v.29 no.4
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    • pp.223-226
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    • 2017
  • Purpose: This study examined two trunk strategies - medio-lateral ramp and anterior-posterior ram - and their effects on pelvis and trunk movements, providing basic material for safe ramp utilization. Methods: The present study included 20 asymptomatic males recruited from a local university. Participants were asked to stand with their feet shoulder-width apart. Their dorsal side faced the camera, and measurements were performed while standing in a neutral double stance, one leg stance, $15^{\circ}$ of medial and lateral ramp, and $15^{\circ}$ of anterior and posterior ramp. Participants were allowed to practice for 3 minutes, and each participant had a 30 seconds rest between the two ramp conditions. One-way repeated measures analysis of variance was used to determine the effects the ramp conditions on spinal alignment. In all analyses, p<0.05 was used to indicate statistical significance. Results: The trunk-inclination angle on the posterior ramp was significantly lower than that of the double stance position (p<0.05). The trunk imbalance angle was significantly higher on the medial ramp, than that on the double stance position (p<0.05). The pelvic position and pelvic torsion angles were significantly higher in the medial, lateral, and anterior ramp positions than that of the double stance position (p<0.05). The pelvic rotation angles on the medial, lateral, and anterior ramps were significantly lower than that of the double stance position (p<0.05). Conclusion: These findings suggest that when people are exposed to the same form of ramp for an extended period, posture modifications may be triggered.