• Title/Summary/Keyword: fatigue index

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Central Sarcopenia, Frailty and Comorbidity as Predictor of Surgical Outcome in Elderly Patients with Degenerative Spine Disease

  • Kim, Dong Uk;Park, Hyung Ki;Lee, Gyeoung Hae;Chang, Jae Chil;Park, Hye Ran;Park, Sukh Que;Cho, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.995-1003
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    • 2021
  • Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.

Analysis on the Changes in Muscle Function of the Leg Joint in Athletics Athletes Through by Whole Body Vibration Exercise Training (전신진동(Whole body vibration)운동훈련을 통한 육상 투척선수의 하지관절 근육 기능변화에 관한 분석)

  • Lee, Youngsun;Yoon, Changsun;Han, KiHoon;Kim, Jinhyun;Hah, Chongku;Park, Joonsung;Kim, Jongbin
    • Journal of Convergence for Information Technology
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    • v.11 no.3
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    • pp.250-260
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    • 2021
  • The purpose of this study is to investigate muscle function and symmetry index during whole body vibration exercise using lower extremity training posture for throwing athletes. For throwing athletes in their 20s(6 males, 4 females, age: 24.60±0.92years, height: 177.90±7.40cm, weight: 92.90±22.97kg), lower extremity training postures with squat, carphrase, and lunge movements. Whole body vibration exercise training was performed using. Tensiomyography(TMG) variables Time Delay(Td), Time Contraction(Tc), Time Sustain(Ts) Time Relaxation(Tr), and Displacement Maximumal(Dm) in the lower extremity joint muscles(biceps femoris(BF), gastrocnemius lateral(GL), gastrocnemius medial(GM), rectus femoris(RF), tibialis anterior(TA), lateral vastus(LV), medial latissimus(ML)), were measured to compare and analyze muscle activity, muscle fatigue, and left-right symmetry. The results of the study are left RF, VL, right VM (p<.05) in Td, VM (p<.05) in Tc, GM in Ts (p<.05), left RF in Tr, and right TA (p<. 05) showed a change. Therefore, it has been proven that various whole-body vibration training is an effective exercise with changes in muscle contraction, and stability of the core is secured by symmetry of the left and right muscles. For this reason, the whole body vibration exercise will have a positive effect on rehabilitation training, and it is believed that it will be able to improve performance.

Comparison of the Medication Effects between Milnacipran and Pregabalin in Fibromyalgia Syndrome Using a Functional MRI: a Follow-up Study (섬유근통 환자에 대한 Milnacipran과 Pregabalin 약물치료에 대한 기능적 자기공명영상에서의 후속 영향 비교)

  • Kang, Min Jae;Mun, Chi-Woong;Lee, Young Ho;Kim, Seong-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.341-351
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    • 2014
  • Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.

Effects of the Experimental Vehicles on the Greenhouse Worker′s Work Load (비닐하우스 작업시 승용 농작업차의 노동부담 경감효과)

  • Choi, Jung-Hwa;Seol, Hyang;Ryu, Kwan-Hee
    • Korean Journal of Rural Living Science
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    • v.8 no.1
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    • pp.7-13
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    • 1997
  • In this study we examined the greenhouse worker's work load to test the efficiency of the developed vehicles (hand operated vehicle (HV), simple battery-powered autonomous vehicle (AV)). The subject of this study were healthy adult females who had experience in growing crops. We measured workers' heart rate, blood Pressure. rectal temperature, mean skin temperature, oxygen consumption and blood lactate level as a physiological index of work load. The results of this study are as follows : The test group using experimental vehicle showed the lower heart rate (mean$\pm$S.D. for HV, AV respectively 74$\pm$5, 75$\pm$3 beats/min, p<0.01) than the control group (84$\pm$8beat/min) not using experimental vehicle and the lower systolic blood Pressure (HV, AV respectively 109$\pm$8, 109$\pm$9 mmHg, p<0.01) than the control group (121$\pm$11 mmHg), and lower rectal temperature(HV, AV respectively 37.0$\pm$0.1, 36.8$\pm$0.2$^{\circ}C$, p<0.01) than the control group (37.0$\pm$0.2$^{\circ}C$), and the less oxygen consumption (HV, AV respectively 2.13$\pm$0.09, 1.66$\pm$0.52$m\ell$/kg/min, p<0.01) than the control group(2.43$\pm$0.12$m\ell$/kg/min), and the lower blood lactate level (HV, AV respectively 2.03$\pm$1.00, 1.66$\pm$0.52mmol, p<0.01) than the control group (2.43$\pm$0.12mmol). Judging from these results, these experimental vehicles for greenhouse workers can be confirmed as a useful tool. It is suggested that these vehicles would alleviate the peasant's syndrome including muscle fatigue and musculoskeletal disease usually caused by working in an uncomfortable posture.

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Study of the Developmental History on Hospice·Palliative Care and Need for Korean Medicine (호스피스·완화의료 발전사와 한의학 참여의 필요성)

  • Yoon, Hae-chang;Son, Chang-gue;Lee, Nam-heon;Cho, Jung-hyo
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.662-675
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    • 2018
  • Objective: The aim of this study was to establish the developmental history of hospice palliative care (HPC) with Korean medicine (KM). Methods: We compared the developmental history of HPC in Korea with that of Britain, the United States, Taiwan, Japan, and China. The articles in English or Korean published until Feb. 2017 were searched using 'Hospice' or 'Palliative care' with the name of each nation in the PubMed, MEDLINE, ScienceDirect, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases for foreign articles and OASIS (Oriental Medicine Advanced Searching Integrated System) for domestic articles. Books and gray literature were searched on the same databases and websites of the Ministry of Health and Welfare and related organizations in each country. Results: Modern palliative care began with the hospice movement led by Dr. Cicely Saunders. HPC in Korea started earlier than in other countries but it took considerable time for social consensus, so Korean policies have only been published recently. In this process, KM was excluded from HPC. For this reason, western medicine in Korea does not fully accept the spirit of HPC, the government does not take an aggressive stance with KM, and the institutes of KM do not have any interest in HPC. The World Health Organization recommends the establishment of policies and programs connected with a country's own health care system. In 2015, the Korean government made the third comprehensive plan for the development of KM. It included critical pathway guidelines about cancer-related fatigue and anorexia. More effort is required to set up HPC than other care types because Korea has two medical systems. Conclusions: Each nation has been trying to improve systems of HPC. We need to overcome the problems and bring out the best by making our own model of HPC with KM.

Health Complaints of Elderly Persons Using a Modified C.M.I. (C.M.I.간이법에 의한 노인들의 건강수소율)

  • 박오장
    • Journal of Korean Academy of Nursing
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    • v.13 no.2
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    • pp.44-57
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    • 1983
  • The explosion of the aging population is changing the social environment of today's older people. Traditionally in Korea, a large percentage(over 90%) of elderly parents have lived with their married first son. But today, the number of elderly who live with their married sons has decreased(65.6%) The number of those who live in a different situation such as with their married daughter, unmarried offspring, with a spouse or alone has increased (34.4%) We can expect that the number of the elderly who have to live in institution will increase. The objective of this investigation was to determine differences in the number of health Complaints of older people according to their living situation with a view to planning more effective health care. The sample consisted of 231 persons over 65 years of age, 60 living in an Old Age Home ana 171 living in their own home in Kwangju. Data were gathered from July 9 to 26, 1983 by nursing students using a Questionnaire which was a modified form of the Cornell Medical Index. The data were categorized according to the subjects, living, sex, educational level, previous occupation, hobbies and sexual activity. The date were analyzed for statistical significant differences using F and X²tests. findings included the following: 1. There was a higher number of health complaints from persons who live in the institution than those living at home, but the difference was not significant. 2. The highest number of health Complaints were from persons who live alone, followed by those living with their daughters, and then by those living in the institution. Persons who live with their sons had the least Complaints. The difference in the number of Complaints accord-ing to with whom they were living was significant. 3. Women had signincantly more Complaints than men. Persons who were not living with their spouses had significantly more complaints than those living with their spouses.4. The higher eductional level the persons had, the less health Complaints they had. The number of Complaints accoraing to educational level was significantly different. 5. The highest number of health complaints were from persons who had involved in Commerce and industry, followed by those in Agriculture. Persons who were civil servant had the least 6. There were more complains from persons who had no hobby than those with hobbies. The complaints. The difference was significant. difference was significant. 7. Persons who said they were sexually inactive had significantly more complaints than those who said they were sexually active. As age increased, sexual activity significantly decreased. Those who lived with their spouse were significantly more sexually active. 8. The highest number of Somatic Complaints were eye fatigue, followed by nocturnal frequency, lumbago, cramps in extremities, vertigo, stiffness in Shoulder, tinnitus, common cold and constipation. The order of Psychic Complaints from higher to lower were anger. sensitivity, anxiety, depression and loneliness. 9. This group of Elderly persons said they valued Health the most, followed by Harmony, Religion, Money and Honor.

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Comparison of Respiratory Symptom between Urban and Rural Residents (도시주민(都市住民)과 농촌주민(農村住民)의 호흡기증상(呼吸器症狀))

  • Yoon, Jung-Suk;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.113-127
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    • 1985
  • This paper was carried out for comparison of respiratory symptoms between urban and rural residents that is somewhat related to air pollution. And as urban residents, 470 persons of Daegu (Taegu) and 364 of Pohang were selected and 472 rural residents were also, in Eusong-Gun, those who were responded to questionnaire distributed from April 10, 1984 to April 30 through students of middle or high school. The subjects were families of the student. The questionnaire was appropriately modified the item B of Cornell Medical Index by author. Looking into the rate of complaints about each part, generally, the rate in urban is higher than that in rural. Particulary it is higher to 'feeling a choking lump or swelling of throat', 'the sputum' and 'the asthma' in the city (p<0.05). On the contrary, women in the farm village, to 'caught a severe cold' as compared with the city. In men under nineteen yearn of age, it is higher than the farm village to 'feeling a choking lump or swelling of throat' of Pohang (p<0.05). But in men forties, it is higher than the city that farm people are 'soaking sweat at night' and 'foreign body sensation on throat'. Students hardly differ between the two areas, while the group having occupation in Pohang felt more in 'feeling a choking lump or swelling of throat' than the farm residents. As the result, I consider that the rural residents were much affected by physical fatigue and pestisides, and the urban, by some problems of industrial fuel, traffic gas and various dusts.

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Effects of Formula (JR-22) Maybe Containing Traditional Herbs on Maximal Exercise Performance and Antioxidant Meterials in Murine Model (생약조성물 투여가 지구력 향상과 항산화 물질에 미치는 영향)

  • 홍성길;양동식;강봉주;이홍석;윤유식
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.7
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    • pp.1076-1081
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    • 2003
  • The effects of dietary supplementation of JR-22, formula containing distilled extracts of traditional herbs on maximal exercise performance and endurance were evaluated in mouse and rat model. In acute forced swimming test with 4%∼8% of the body weight attached to the tail, it was shown that dietary JR-22 supplementation increased endurance in exercise performance. There was no change of blood lactic acid, ammonia, inorganic phosphorous ion and creatine kinase activity, however ATP concentration in muscle was increased by JR-22 supplementation. Also, insulin-like growth factor-l (IGF-1) concentration in blood was significantly increased by JR-22 supplementation. In addition, the oxidative damage induced by exercise was reduced by JR-22 supplementation. In these results, we suggested that JR-22 supplementation enhanced maximal endurance exercise performance by the mechanism of increasing ATP and IGF-1 concentration and reducing oxidative damage.

Influence on Predicted Performance of Jointed Concrete Pavement with Variations in Axle Load Spectra (축하중 분포 변화가 콘크리트 포장의 공용성 예측결과에 미치는 영향 연구)

  • Lee, Kyungbae;Kwon, Soonmin;Lee, Jaehoon;Sohn, Duecksu
    • International Journal of Highway Engineering
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    • v.16 no.1
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    • pp.11-19
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    • 2014
  • PURPOSES : The purpose of this article is to investigate the predicted life of jointed concrete pavement (JCP) with two variables effecting on axle load spectra (ALS). The first variable is different data acquisition methods whether using high-speed weigh-in-motion (HS-WIM) or not and the other one is spectra distribution due to overweight enforcement on main-lane of expressway using HS-WIM. METHODS : Three sets of ALS had been collected i) ALS provided by Korea Pavement Research Program (KPRP), which had been obtained without using HS-WIM ii) ALS collected by HS-WIM before the enforcement at Kimcheon and Seonsan site iii) ALS collected after the enforcement at the same sites. And all ALS had been classified into twelve vehicle classes and four axle types to compare each other. Among the vehicle classes, class 6, 7, 10 and 12 were selected as the major target for comparing each ALS because these were considered as the primary trucks with a high rate of overweight loading. In order to analyze the performance of JCP based on pavement life, fatigue crack and International Roughness Index (IRI) were predicted using road pavement design program developed by KPRP and each ALS with same annual average daily traffic (AADT) was applied to design slab thickness. RESULTS : Comparison ALS of KPRP with those of HS-WIM shows that the ALS of KPRP has a low percentage of heavy spectra such as 6~9 tonnes for single axle, 18~21 tonnes for tandem axle and 27~30 tonnes for tridem axle than other two ALS of HS-WIM in most vehicle classes and axle types. It means that ALS of KPRP was underestimated. And after the enforcement, percentage of heavy spectra close to 10 tonnes per an axle are lowered than before the enforcement by the effect of overweight enforcement because the spectra are related to overweight regulation. Prediction results of pavement life for each ALS present that the ALS of HS-WIM collected before the enforcement makes the pavement life short more than others. On the other hand, the ALS of KPRP causes the longest life under same thickness of slab. Thus, it is possible that actual performance life of JCP under the traffic like ALS of HS-WIM could be short than predicted life if the pavement was designed based on ALS provided by KPRP. CONCLUSIONS : It is necessary to choose more reliable and practical ALS when designing JCP because ALS can be fairly affected by acquisition methods. In addition, it is important to extend performance life of the pavement in service by controlling traffic load such as overweight enforcement.

Study on the Characteristics of Ordinary Symptoms in Overweight and Obesity Patients according to Sasang Constitution (사상체질에 따른 과체중 및 비만 환자의 소증(素證) 특성 비교)

  • Shin, Seung Won;Lee, Junhee
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.1
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    • pp.33-45
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    • 2013
  • Objectives: This study was aimed to find out the characteristics of ordinary symptoms between the control and patient groups, diagnosed as overweight or obesity, in Soyang, Taeeum, and Soeum Constitutions and among those 3 groups. Methods: As a prospective cross-sectional study based on medical records, 9213 patients, who visited Kyung Hee University Medical Center from May in 2007 to June in 2010, were included. To diagnose the constitution, Revised Questionnaire for the Sasang Constitution Classification II and examinations by oriental medical doctors who majored in Sasang Constitution Medicine were performed. Based on the World Health Organization criteria for Asian obesity assessment, body mass index (BMI) was classified into 3 groups; more than 25 as obesity, 23 to 25 as overweight, and less than 23 as normal. Ordinary symptoms questionnaire, which consists of 46 questions in 8 categories, were given to the subjects. One-way ANOVA test in continuous variables and chi-square test in categorical variables were carried out to analyze statistical significance. Results and Conclusions: 1) In general characteristics, we could find out the significant differences in age, sex, height, weight, BMI, waist circumference, blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood sugar, and hemoglobin A1c among the 3 Constitutional groups. 2) Soyang Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 3) Taeeum Constitution of overweight and obesity has tendency to have higher appetite, like cool or cold water, defecate more, swear more, dislike heat, and have warmer or hotter extremities in the ordinary symptoms, compared with the control group. 4) Soeum Constitution of overweight and obesity has tendency to have higher appetite and less fatigue in the ordinary symptoms, compared with the control group. 5) Soeum Constitution showed the slightest increase in appetite, preference about room temperature water, less number of feces, and feeling of chill and warmer extremities in ordinary symptoms, compared with Soyang and Taeeum Constitutions. Taeeum Constitution showed the distinct increase in appetite and sweating in ordinary symptoms, compared with Soyang and Soeum Constitutions.