• 재활치료과학
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• 제4권1호
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• pp.19-28
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• 2015

서론 : 실행증과 관련된 신경학적 손상에 대한 이해는 병변 부위에 따른 증상을 예측하고 적절한 치료와 목표를 구성하는데 기반이 될 수 있다. 따라서 본 연구는 문헌고찰을 통하여 관념운동실행증의 원인과 행동 오류의 기전을 알아보고, 이와 더불어 치료에 이용될 수 있는 근거를 제시하고자 한다. 본론 : 실행의 모델에서 알 수 있듯이 관념운동실행증은 실행 시스템에서 생산적 측면만의 손상으로 발생할 수 있으며 신경학적 부위는 피질하 손상보다는 피질 수준의 손상이 더 흔하다. 제스쳐를 통한 연구에 따르면 팔의 동작과 관련하여서는 왼쪽 두정엽, 손가락 자세에 따른 동작은 전두엽의 기능과 관련이 있다. 실제 물체를 사용함으로써 얻어질 수 있는 시각, 촉각의 자극들은 익숙한 동작에 대한 기억과는 별도로 올바른 동작을 유도시킬 수 있다. 결론 : 실행은 다양한 신경학적 부위의 처리 과정을 통해 일어나며 다양한 외부의 자극들이 실행에 도움을 줄 수 있음으로 관념운동실행증의 치료에는 이러한 자극들을 이용하는 것이 필요할 것이다.

• 대한한의학회지
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• 제36권2호
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• pp.43-49
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• 2015

Objectives: We evaluated the effect of the traditional Korean medical therapy of catgut-embedding therapy in patients with carpal tunnel syndrome (CTS). Methods: Thirteen patients(20 hands) with CTS underwent catgut-embedding therapy once per week for a total of 1-4 sessions. We measured the time to tingling in the fingers on performing Phalen's test. We also had patients use a visual analog scale (VAS) to indicate the severity of tingling. We also asked about the awakening time at night due to pain and tingling. We controlled the treatment as being limited to four sessions. Even if a patient had not been treated for four sessions, we ended the patient's treatment if symptoms resolved. Results: Patients who received catgut-embedding therapy showed significant improvements in the clinical symptoms of CTS. After treatment, in a total of 19 hands, the status of fourteen was changed from positive to negative in Phalen's test and the average of tingling occurrence time in that test was delayed. Among the 20 hands, the VAS in eight hands changed to zero and the average of VAS score decreased. Furthermore, in nine patients, four could sleep well without the use of a splint. Conclusions: Patients undergoing this traditional Korean medical therapy showed alleviation of finger tingling after even a single treatment. We thus concluded that this traditional Korean catgut-embedding therapy, may be effective for treating CTS. However, to confirm the effects of catgut-embedding therapy on CTS, further tests are required, including under the defined, strict conditions of a randomized controlled trial.

• 대한정형도수물리치료학회지
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• 제15권2호
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• pp.8-14
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• 2009

Purpose: to apply lymph massage to the patients that contracted lymphedema after mastectomy to resolve blood congestion, stimulate circulation, and control swelling long-term. Methods: The subjects include 20 female patients that were diagnosed with breast cancer histologically and contracted lymphedema within one to two years after mastectomy. They received lymph massage from March to August, 2008. Using a measuring tape(capable of measuring mm), the arm circumference was measured in both the sick and normal arm. Only the data from the sick arm were compared before and after the treatment. The measuring points were five; the back of the hand(a certain distance[about 10cm] was set between the end of the middle finger to the center of the palm), the wrist(the smallest section), the lower arm(at a certain distance[about 10cm] from the internal bending part of the elbow), the elbow(the bending part), and the upper arm(at a certain distance[about 10cm] from the internal bending part of the elbow). Collected data were analyzed using the SPSS/WINDOWS Version 12.0 program. Results: There was a reduction of lymphedema observed in all the points including 10cm in the upper arm, the elbow, 10cm in the lower arm, the wrist and the back of the hand after lymph massage, and the reduction had statistically significant differences(p<.05). Conclusion: Those results indicate that lymph massage has effects on the reduction of lymphedema in the early patients that contracted it after mastectomy.

• 한국전문물리치료학회지
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• 제14권3호
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• pp.72-80
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• 2007

The purpose of this study was to verify the effects on fine motor, muscle strength (hand-grip), explosive muscular strength (vertical jump) and muscular endurance (sit-up) after ingesting coffee. Hence this study targeted a sample group of 38 healthy men in their twenties, without cardiac disorders and muscle disorders and none of them were hypersensitive to caffeine with symptoms such as palpitation and dyspnea. Nineteen of them ingested coffee, whereas the other nineteen men ingested decaffeinated coffee at the same amount. The amount of coffee was controlled by weight so as to regulate intake to 6 mg caffeine per kg. Research material was evaluated through O'Conner's finger dexterity test, hand-grip strength test, vertical jump test and sit-up test. The data were analyzed by means of paired t-test and ANCOVA. The material was then, analyzed by means of two-way ANOVA in order to verify the effect of one or two cups of coffee on fine motor and hand-grip strength. All parameters were measured by an independent observer. The results were as follows: There were no significant differences to fine motor, hand-grip strength, vertical jump, sit-up before and after drinking decaffeinated coffee, but there was a difference to those before and after drinking caffeine coffee. There was no significant difference to hand dexterity and hand-grip strength in one or two cups of coffee. Intake of a certain dosage of caffeine effects activation of muscles working in a short period based on the results. As a consequence, intake of certain dosages of caffeine was beneficial to enhance efficiency of activity during exercises, but it is will be difficult to obtain the desired result with only one or two cups of coffee.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.642-648
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• 2011

Purpose: The recent advances in microsurgical techniques and their refinement over the past decade have greatly expanded the indications for digital replantations and have enabled us to salvage severed fingers more often. Many studies have reported greater than 80% viability rates in replantation surgery with functional results. However, replantation of multi-level amputations still remain a challenging problem and the decision of whether or not to replant an amputated part is difficult even for an experienced reconstructive surgeon because the ultimate functional result is unpredictable. Methods: Between January of 2002 and May of 2008, we treated 10 multi-level amputated digits of 7 patients. After brachial plexus block, meticulous replantation procedure was performed under microscopic magnification. Postoperatively, hand elevation, heat lamp, drug therapy and hyperbaric oxygen therapy were applied with careful observation of digital circulation. Early rehabilitation protocol was performed for functional improvement. Results: Among the 19 amputated segments of 10 digits, 16 segments survived completely without any complications. Overall survival rate was 84%. Complete necrosis of one finger tip segment and partial necrosis of two distal amputated segments developed and subsequent surgical interventions such as groin flap, local advancement flap and skin graft were performed. The overall result was functionally and aesthetically satisfactory. Conclusion: We experienced successful replantations of multi-level amputated digits. When we encounter a multi-level amputation, the key question is whether or not it is a contraindication to replantation. Despite the demand for skillful microsurgical technique and longer operative time, the authors' results prove it is worth attempting replantations in multi-level amputation because of the superiority in aesthetic and functional results.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.80-87
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• 2021

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

• 대한물리치료과학회지
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• 제16권3호
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• pp.19-27
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• 2009

Background: To study the effect of the home exercise program on pain, flexibility, endurance of extensor in chronic back pain patients, and suggest optimal method for home exercise program. Methods: I divided into two groups who has chronic back pain; one is control group who was given a treatment at the hospital only and the other is experimental group who did another exercise after treatment at the hospital, and there were 10 people in each group. The manual therapy were given to all the patients in each group after applying a stupe and an electric treatment, but the experimental group conducted another exercise program at homes. All the exercise programs were applied to patients 12 times for 4 weeks totally. Result: SPSS for win version 12 was used for statistic analysis and independent t-test was used to find changes between two groups. VAS scale was used to show changes in pain between each group. The grade of pain was decreased between pre&post test to -5.60 in control group and -4.80 in experimental group but there wasn't significant difference between each group. Finger tip-to-floor test was used for the flexibility changes and it was increased between pre&post test in both groups but the change of flexibility between each groups didn't show statistical difference. Biering-Sorensen test was used to measure the endurance of extensor and it was increased between pre&post test in both groups but there wasn't significant difference between each group. Conclusion: As you read the results above, for a chronic low back pain patient, application of the manual therapy showed that it has effect on decrease of low back pain, increase of flexibility and endurance of extensor. However, the effect of home exercise treatment was not sure about improvements for chronic low back pain patient. So I think there should need further study about the effect of home exercise treatment except the treatments at hospital and the thorough education for the exercise of lumbar should be done before the study for the accurate experiment.

• 대한통합의학회지
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• 제8권1호
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• pp.47-56
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• 2020

Purpose : The purpose of this study was to determine the effects of upper extremity volume, pain, and range of motion after participation in thera-band exercises according to the hand grip type in patients with breast cancer with upper extremity edema. We also aimed to determine the most efficient type of grip. Methods : The subjects were 10 female patients diagnosed with stage 2 breast cancer who had stage 2 lymphedema. Randomly, 5 patients each were allocated to the experimental and control groups. For six weeks, the patients in both the experimental and control groups exercised daily. In both groups, manual lymph drainage was applied for 1 hour. Afterward, patients in the experimental group placed their hands in the thera-band ring and exercised with their fingers outstretched. Patients in the control group exercised while holding the thera-band ring with a finger. Both the experimental group and the control group underwent measurements of the circumference of the upper extremity, pain, and range of motion of the shoulder joint at weeks 1, 2, 4, and 6 before and after exercise. Results : The upper arm circumference decreased by more in the experimental group in all weeks than before than that in the control group, and there was a statistically significant difference at 6 weeks. Compared with the difference between pre-exercise and 6 weeks post-exercise, the change in pain significantly decreased in the experimental group and showed a statistically significant difference. The shoulder range of motion increased in extension, external rotation, and internal rotation compared with that in the control group, and there was a statistically significant difference. Although the operating range increased in flexion and abduction, there were no statistically significant differences. Conclusion : In this study, we found that thera-band exercises with an open-hand grip are more efficient than thera-band exercises with a closed-hand grip in edema reduction, pain, and range of motion. In addition, it was found that it was more effective to continue the thera-band exercises with open-hand grip extended for at least 6 weeks rather than for a short time.

• 한국산학기술학회논문지
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• 제18권1호
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• pp.336-344
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• 2017

본 연구는 뇌손상 진단을 받고 병원에서 재활치료를 실시하고 있는 환자의 가족 간병인 340명을 대상으로 근골격계증상을 알아보고 그 관련요인을 파악하고자 자기 기입식 설문조사를 실시하였다. 설문조사 내용은 일반적 특성, 간병활동 특성, 근골격계 자각 증상이였다. 본 연구의 조사 기간은 2014년 3월부터 4월이며, 재활병원 및 요양병원에서 수집하였다. 연구결과 독립변수에 따른 자각증상 호소율은 신체부위별로 다르게 나타났다. 요인분석의 결과는 목의 경우 초졸의 학력이 영향을 끼쳤고, 어깨의 경우 여자, 나이 50~59세, 학력 중졸, 간병기간 1년 이내와 1년 7개월 이상 2년 이내가 영향을 끼쳤다. 팔/팔꿈치의 경우 나이 40~49세, 학력 대졸, 간병기간 1년 이내와 1년 7개월 이상 2년 이내 변인이 유의한 영향을 끼쳤다. 손/손목/손가락의 경우 나이 50~59세, 간병기간 1년 이내와 1년 7개월 이상 2년 이내 변인이 통증에 유의한 영향을 끼쳤다. 다리/발의 경우 나이 50~59세, 간병기간 6개월 이내 변인이 통증에 유의한 영향을 미치는 것으로 나타났다. 허리의 경우 학력 초졸 중졸 고졸, 간병기간 1년 이내와 1년 7개월 이상 2년 이내, 독립보행 불가능 변인이 통증에 유의한 영향을 미치는 것으로 나타났다. 진단명 별 간병활동 특성에서 근골격계 자각증상 호소율은 통계적으로 유의하지 않았다. 근골격계 자각증상 호소에 가장 영향을 미치는 간병활동 동작으로는 이동하기와 보행이었다. 근골격계 자각증상에 영향을 미치는 전체 요인에 대해서는 간병 기간 1년 이내가 전체 통증에 유의한(p<.05) 영향을 미치는 것으로 나타났다. 본 연구의 결론으로는 뇌손상 환자의 가족 간병인은 환자를 간병하는 간병활동 특성에서 근골격계 질환의 위험에 노출되어 생활하는 것을 알 수 있었다. 또한 뇌손상 환자를 돌보는 가족 간병인의 신체부위별 근골격계 증상에 영향을 미치는 요인이 다르므로 이러한 요인에 대한 체계적이며 종합적인 예방 교육과 연구가 마련되어야 할 것이다.