• Title/Summary/Keyword: lower extremities

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Continuous Epidural Analgesia of Lidocaine and Morphine for the Management of Ureteral Calculi (Lidocaine 및 Morphine경막외차단에 의한 뇨관 결석의 치험)

  • Cho, Gong-Lae;Hur, Nam-Jin;Roh, Un-Suk;Cho, Sung-Kung;Lee, Sang-Hwa
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.21-25
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    • 1989
  • For the simple operations of the perineal region, caudal, epidural and saddle blocks of analgesia are preferable anesthesia techniques in men. But, if the operations shoud be delayed or the physicians are willing to observe and manipulate the patients for a couple of days, as in the ureteral stone manipulation, continuous epidural analgesia will be a reliable method. The authors have observed 36 male patients of ureteral calculi with continuous lumbar epidural analgesia for the purpose of elimination of an undesirable pain sensation which was associated with the transurethral cystoscopic manipulation. The results were as follows: 1) In most cases, the anesthetics used were 1% lidocaine 20 ml through the $L_{3-4}$ and $L_{4-5}$ interspace with 4~6cm of catheter tip advancement mainly to cephalad. 2) There was no motor weakness or paralysis in the lower extremities except some numbness and paresthesia on the perineal area. 3) Besides the various minor complications, there were no problems in respiration with small doses of morphine extradurally. 4) Among them, four cases of ureteral calculi dropped into the bladder spontaneously due to the epidural technique during transportation of the patients from the pain clinic to the urology out-clinic. One case of calculi was dropped by the aid of instrumentation at the ward, and twelve cases of calculi were removed directly by Dormia stone basket in the scopic room. For the remaining patients, we deduced that their calculi was be evacuated out because there were no complaints were notified after discharge.

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Correlation between lateral abdominal, rectus femoris, and triceps brachii muscle thickness and endurance during prone bridge exercise in healthy young adults

  • Lee, Kyeong Bong;Kim, Jong Geun;Park, Han Gi;Kim, Ji Eun;Kim, Hye Sun;Lee, Wan Hee
    • Physical Therapy Rehabilitation Science
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    • v.4 no.1
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    • pp.11-16
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    • 2015
  • Objective: Prone bridge exercise is one of the core strengthening exercise for improving abdominal, lower and upper extremity muscles. In addition, coactivation of the trunk muscles and extremities is important for treatment of low back pain. This study aimed to investigate the correlation between the thickness, cross-sectional area of the target muscle, and endurance during prone bridge exercise. Our hypothesis was that an increase in muscle thickness is positively related to the hold time for the static prone bridge exercise. Design: Cross-sectional study. Methods: Fourteen healthy university students (8 men and 6 women) voluntarily participated in the study at Sahmyook University. Hold time for the prone bridge with one and both legs was measured. The resting and contracted thickness of the lateral abdominal, rectus femoris, and triceps muscles was measured using rehabilitative ultrasound imaging. The correlation between muscle thickness and endurance for maintenance time was evaluated. Results: The prone bridge with both legs and the contraction thickness of the triceps muscle showed a positive correlation (r=0.692, p<0.05); the prone bridge with one leg and the contraction thickness of the internal oblique and transversus abdominis muscles showed a positive correlation (r=0.545, 0.574, p<0.05, 0.05, respectively). Conclusions: Endurance for the prone bridge exercise with a stable support surface is correlated with the contraction thickness of arm muscles; the prone bridge exercise with an unstable support surface is correlated with the contraction thickness of the deep abdominal muscles.

Eight and a Half Syndrome: A Clinical Study of 2 Cases (8과 1/2 증후군 2례)

  • Park, Ji-Min;Kim, Jong-Han;Yoo, Je-Hyuk;Yoon, Ga-Young;Nam, Dong-Woo;Lee, Sang-Hoon;Kim, Jong-In
    • Journal of Acupuncture Research
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    • v.29 no.3
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    • pp.139-148
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    • 2012
  • Objectives : The purpose of this case is to report the improvement of two patients diagnosed with eight and a half syndrome after combination therapy of oriental and western medicine. Methods : We treated the patients with combination therapy of oriental and western medicine such as acupuncture, moxibustion, herbal medication, antithrombotic agents and steroid therapy. Changes of peripheral facial paralysis were evaluated using House-Brackmann facial grading system and the degree of dizziness, tenderness and pain of upper abdomen were assessed using numerous rating scale. Changes in motor grade of upper and lower extremities were evaluated using medical research council scale. Results : We have recently experienced two cases of eight and a half syndrome - a syndrome characterized by the coexistence of one and a half syndrome, a rare ophthalmoparetic syndrome characterized by a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other, and cranial nerve VII palsy. The one and a half syndrome was caused by acute cerebral infarction. Two patients in this report were improved through combination therapy of oriental and western medicine. Conclusions : We report the clinical course and treatment methods of eight and a half syndrome.

Effects of Slump Sitting Posture on the Masticatory, Neck, Shoulder, and Trunk Muscles Associated With Work-Related Musculoskeletal Disorders

  • Yoo, Won-Gyu;Yi, Chung-Hwi;Kim, Han-Sung;Kim, Min-Hee;Myeong, Seong-Shik;Choi, Hyun-Ho
    • Physical Therapy Korea
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    • v.13 no.4
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    • pp.39-46
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    • 2006
  • The purpose of this study was to determine the effects of slump sitting postures on the masticatory, neck, shoulder, and trunk muscles associated with work-related musculoskeletal disorders (WRMD). Eleven healthy adults (age, $23.3{\pm}2.7$ yrs; height, $174.0{\pm}4.1$ cm; weight, $61.4{\pm}6.6$ kg) participated in this study. The participants were free of injury history and neurologic deficits in the masticatory, neck muscles and upper extremities at the time of participation. The subjects were asked to perform erect and slump sitting postures under the guidance of physical therapists. The surface electromyography (EMG) was recorded from the anterior temporalis, masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique, gluteus maximus muscles of 11 adults as they performed visual terminal display work, which are known as the weakened and tightened muscles owing to WRMD. The recorded signals were averaged and normalized to the mean amplitude of the EMG signal obtained during submaximal reference voluntary contractions. The results of study were as follows: The masseter, upper trapezius, serratus anterior, middle trapezius, L3 paraspinal, external abdominal oblique muscles significantly differed in the slump sitting posture (p<.05). The muscle activities of the serratus anterior, middle trapezius muscle, and external abdominal oblique were significantly lower and that of the masseter, upper trapezius, L3 paraspinal muscles were significantly higher. Further research is needed to assess the motor control problems and the function of the deep muscles in posture stability of patients with WRMD.

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Effect of a Elderly Walker on Joint Kinematics and Muscle Activities of Lower Extremities Using a Human Model (인체 모델을 이용한 노인 보행기의 하지관절 기구학과 근활성에 미치는 영향)

  • Shin, Jun-Ho;Kim, Yoon-Hyuk
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.11
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    • pp.1243-1248
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    • 2011
  • The purposes of this study were to develop a dynamic model of a human and to investigate the effect of a walker on an elderly subject's motions, such as sit-to-stand (STS) motion and normal gait, by using this model. A human model consisting of 15 segments and 14 joints was developed, embedded in $RecurDyn^{TM}$, and connected through a Simulink$^{(R)}$ interface with collected motion data. The model was validated by comparisons between joint kinematic results from inverse dynamics (Matlab$^{(R)}$-based in-house program) and from $RecurDyn^{TM}$ simulation during walking. The results indicate that the elderly walker induced a longer movement time in walking, such that the speed of joint flexion/extension was slower than that during a normal gait. The results showed that the muscle activities of parts of the ankle and hamstring were altered by use of the elderly walker. The technique used in this study could be very helpful in applications to biomechanical fields.

Nerve Conduction Study of Lateral Dorsal Cutaneous Branch of Sural Nerve (비복신경 외측분지의 신경전도검사)

  • Kim, Sung-Je;Lee, Dong-Kuck
    • Annals of Clinical Neurophysiology
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    • v.5 no.2
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    • pp.192-196
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    • 2003
  • The Lateral dorsal cutaneous branch of sural nerve (LDCB) is a terminal sensory branch of lower extremities. It can be injured frequently in peripheral nerves. However, the normal data of each component of nerve conduction study (NCS) of were not studied at this time. The Nerve Conduction Study of LDCB adults were assessed for amplitude, area, duration and nerve conduction velocity (NCV) in normal fifty. We also evaluated how age, sex and dexterity affect the various components of NCS. The Mean amplitude of LDCB was $9.45{\pm}1.93{\mu}V$, area was $4.05{\pm}0.55{\mu}V/s$, duration was $1.50{\pm}0.13s$, and NCV was $37.9{\pm}3.09m/s$, respectively. The amplitude of right was $10.1{\mu}V$ in men, $8.65{\mu}V$ in women. The area of right was $3.83{\mu}V/s$ in less than 40 years and $4.24{\mu}V/s$ in older than 40 years. The areas of left was $3.86{\mu}V/s$ in less than 40 years and $4.30{\mu}V/s$ in older than 40 years. The NCV was 39.0 m/s in less than 40 years and 36.7 m/s in older than 40 years. All of above differences were statistically significant. There were no statistically significant differences between right and left NCS. Normal data of LDCB could be applicable in peripheral neuropathy or nerve injury.

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The Current Status of Cerebral Palsy Patients in Handicapped Residential Facility (장애인 집단보호시설에서 뇌성마비 환자의 현황)

  • Lee, Dong-Hee;Oh, Ki-Young;Lee, Kyu-Hoon;Choi, Ki-Sub;Kim, Mi-Jung
    • The Korean Journal of Rehabilitation Nursing
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    • v.7 no.1
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    • pp.96-104
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    • 2004
  • Purpose: The aim of this study is to evaluate the general status and prevalence of cerebral palsy, the complication and the activity of daily living in patients with cerebral palsy in Holt Ilsan Home. Methods: Cross-sectional study was performed on 113 cerebral palsy patients in Holt Ilsan Home with the medical records review, the physical examination, and the Modified Barthel index for the independency of activities of daily living. Results: The mean age of subjects was $28.1{\pm}12.7$ years and the duration of residence was $22.9{\pm}12.8$ years. The most common type of cerebral palsy according to the muscle tone abnormality was spastic type(53.1%). The most frequent condition in which extremities are involved were quadriplegia in 46.0%. The score of Modified Barthel index was significantly lower in mixed type for $16.9{\pm}24.0$ and quadriplegic type for $14.8{\pm}25.5$ compared with others. Conclusion: This study indicates that cerebral palsy patients in rehabilitation facility have severe medical problems such as musculoskeletal complications, visual and language problems, epilepsy and dependency in activities of daily living. Therefore more medical attention like long-term follow-up study and social supports is needed.

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The changes of rectus abdominis muscle thickness according to the angle during active straight leg raise

  • Lee, Hwang Jae;Shin, Kil Ho;Byun, Sung Mi;Jeong, Hyeon Seo;Hong, Ji Su;Jeong, Su Ji;Lee, Wan Hee
    • Physical Therapy Rehabilitation Science
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    • v.2 no.1
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    • pp.44-48
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    • 2013
  • Objective: The purpose of this study was to investigate changes of abdominal muscles thickness according to the angle during the active straight leg raise (ASLR) in young healthy subjects. Design: Cross sectional study. Methods: Twenty-three healthy university students (13 men and 10 women) voluntary participated to the study in S University. The ASLR was performed with the subject lying supine with lower extremities straight on a standard plinth, hands resting on the chest, and elbows on the plinth. When one subject performed ASLR from each angles ($30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $90^{\circ}$), compared changes in the thickness of rectus abdominis muscle. Changes in muscle thickness during ASLR test were assessed with ultrasonography. All subjects were to provide enough time of rest after performed ASLR. Rectus abdominis thickness were measured using rehabilitative ultrasound image. Results: Good quality rectus abdominal muscle activation data were recorded during ASLR. The length changes of linea alba showed significantly shorter in between $0^{\circ}$ and $30^{\circ}$ (p<0.05). The thickness of rectus abdominis muscle were significantly different between $0^{\circ}$ and $30^{\circ}$, $0^{\circ}$ and $45^{\circ}$, $0^{\circ}$ and $60^{\circ}$, $0^{\circ}$ and $90^{\circ}$. According to increase of pelvic angle, the thickness of rectus abdominis muscle were more thickening (p<0.05). Conclusions: This result is changes of abdominal muscles thickness according to the angle during the ASLR.

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The Anthropometric Factors in Isokinetic Peak Torque of Young Female Dancers (무용전공 여대생들의 등속성 최대우력에 영향을 미치는 인체계측적 요인)

  • Won, Jong-Im;Lee, Young-Jung
    • Physical Therapy Korea
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    • v.14 no.3
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    • pp.41-47
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    • 2007
  • Dance movements consist of combinations of movements such as jumping, rotation, maintaining balance, leg lifts, and plantar flexion with toe shoes. Dance movements require great muscle strength of lower extremities as well as muscular endurance. The purposes of this study were to investigate correlation between the anthropometric variables and the peak torque in young female dancers and to identify variables that affect isokinetic peak torque. Twenty-six female dancers ($19.7{\pm}1.2$ years of age) performed concentric maximum force efforts on the knee extensors and flexors at $60^{\circ}/sec$ and $120^{\circ}/sec$, the ankle plantar flexors (PF) and dorsiflexors (DF) at $30^{\circ}/sec$ and $120^{\circ}/sec$. Antropometric variables such as age, height, weight, body mass index (BMI), thigh girth, calf girth and duration of dance training were measured. To identify antropometric variables related to muscle strength, Pearson correlations were computed and a stepwise multiple regression analysis was performed. Pearson correlation coefficients of Knee extensor at $60^{\circ}/sec$ and $120^{\circ}/sec$ revealed moderate positive associations with BMI and thigh girth. Pearson correlation coefficients of ankle PF revealed low-to-moderate positive associations with height. Ankle DF also revealed moderate positive associations with BMI and calf girth. The main predictor variables of knee extensor at 60/sec, were stepwise multiple regression, age, height, thigh and girth.

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Both Carotid Endarterectomy in Obstrution of Carotid Arteries and Bypass Graft with Kidney Preservation in Obstrution of Abdominal AoRta -A Report of Case (양측 경동맥협착의 혈관내막절제수술 및 신장보호액 주입을 이용한 복부대동백 폐색 수술 치험 -1례 보고-)

  • 김병철;편승환
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.625-630
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    • 1997
  • A 56 years old male patient adklitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. (infers and weakness on grasping, which were progressively developed re ently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We plamled staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later We obligately clamped aorta just below the celiac artery and infuse4 kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative courts was uneventful and patient was discharged without any specific problem.

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