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The Coordinative Locomotor Training Intervention Strategy Using the ICF Tool to Improve the Standing Posture in Scoliosis: A Case Report

  • Lee, Jeong-a;Kim, Jin-cheol
    • The Journal of Korean Physical Therapy
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    • v.33 no.1
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    • pp.7-15
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    • 2021
  • Purpose: This study was examined to improve the standing posture of a scoliosis client using the ICF Tool. Methods: For examination, the study subject was a 16-year-old female student diagnosed with 3curve-pelvic (3CP) type scoliosis. Information about her were collected through a client interview and based on international Classification of Functioning, Disability and Health (ICF). The ICF core set was for post-acute musculoskeletal conditions, and the ICF level 2 items suggested by National Rehabilitation Information Center (NARIC) were added to the recommendations for scoliosis. For evaluation, the ICF assessment sheet was used to identify the interaction among the problems. For the diagnosis, the client's functional problems were described in ICF terms. For the prognosis, the global goals for reaching the client's functional activity and participation level were presented as the long-and short-term goals. For the intervention, a coordinative locomotor training program composed of warm-up, main exercise, and cool-down was applied 3 times a week, 50 minutes a day, for 5 weeks. For the outcome, the differences between before and after the intervention were compared with the ICF qualifier and are shown with the ICF evaluation display. Results: Clinical advantages were observed in body function and structure (7° decrease of thoracic angle, 7 score increase of trunk muscle power, 6.47s improve of one leg standing, 4 score decrease of neck pain). The activity for maintaining the standing posture, in which the client had a primary limitation, was improved. Conclusion: Applying the coordinative locomotor training program is expected to improve scoliosis client's standing posture.

A Comparative Study on the Characteristics of Performance-related Musculoskeletal Symptoms between Orchestra Performers and University Student Performers (관현악단 전문 연주자와 대학생 연주자의 연주 관련 근골격계 증상의 발생 특성에 관한 비교)

  • Hye-won, Shin;Suhn-yeop, Kim
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.3
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    • pp.21-32
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    • 2022
  • Background: Instrument players are exposed to occupational musculoskeletal symptoms due to constant movement and strain to meet the needs of their audience. This can cause dissonance between the player and the instrument and can cause medical problems in the musculoskeletal system such as pain, tendinitis, muscle spasms, and joint hyperextension from overuse of body parts. Objective: The purpose of this study is to comparatively analyze the characteristics and occurrence of musculoskeletal symptoms in professional and student players, and to find out the awareness of the need for health care professionals and special exercise programs for orchestra players. Methods: The subjects were professional orchestral musicians 191 from the three symphony orchestras and music students 209 from the four universities volunteered to participate in this study; 393 subjects (98.25%) completed the questionnaire. symptom prevalence and related factors of playing-related musculoskeletal disorders (PRMDs) were surveyed with a self-administered questionnaire. Standardized Nordic Questionnaire was complemented by adding a visual-among scale and used to diagnose PRMD. Results: High prevalence of musculoskeletal complaints in both professional musicians (85.30%) and student musicians (82.30%). Professional musicians and student musicians also suffered the highest problem in shoulder and neck complaints. Significant differences were found between groups that recognized of necessity for specialized health professionals, professional organizations, and special programs for musicians. Conclusions: Professional musicians and student musicians, like orchestra players, are already exposed to overuse syndrome. However, student musicians lack awareness of the risk of injury compared to orchestra players. We suggest that an appropriate treatment management program for the prevention and early treatment of musculoskeletal system damage should be provided to performers at an early stage.

Acute Compartment Syndrome Induced by Rhabdomyolysis Due to Antipsychotic Drug Overuse (항정신병 약물 과량 복용 후 발생한 횡문근융해증으로 인한 급성 구획증후군)

  • Hwang, Seok-Ha;Hong, Sung-Ha;Suh, Seung-Pyo;Kim, Joo-Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.276-280
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    • 2020
  • A 49-year-old male was found unconscious at his accommodation and visited the emergency room. He was on antipsychotic and antidepressant drugs (vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, and alprazolam) for schizophrenia and major depression. At the time of discovery there were signs of overdose of the drugs around the patient. A physical examination revealed, pain, pallor, and edema in the left buttocks and lateral thigh. Active ankle movements below the left ankle were not possible and sensations in the tibia and peroneal nerves were lost. The pressure in the buttock compartment was measured at 42 mmHg. Magnetic resonance imaging revealed edema and high intensity signals in the left hip muscles and surrounding soft tissue. An emergency fasciotomy was performed and partial restoration of the lower extremity sensation and muscle strength were achieved after 24 hours.

A Survey on Doctor of Korean Medicine's Recognition for Developing Korean Medicine Clinical Practice Guideline of Sanhupung (산후풍 한의표준임상진료지침 개발을 위한 한의사 인식 조사)

  • Kim, Yu-Been;Hwang, Su-In;Yoon, Young-Jin;Kim, Dong-Il;Park, Jang-Kyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.4
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    • pp.1-18
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    • 2022
  • Objectives: This survey was conducted to research Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung, and to use it as a basic data for the development of Korean Medicine Clinical Practice Guideline for Sanhupung. Methods: From October 1, 2021 to November 1, 2021, a self-administered questionnaire was conducted on an online survey platform targeting Korean Medicine doctors belonging to The Association of Korean Medicine, and the responses were analyzed. Results: Patients most commonly visited Korean Medical clinic within 22 to 42 days of miscarriage or childbirth, and the average treatment period was 1 to 3 months. To diagnose Sanhupung, Korean Medicine doctors most frequently identified the characteristic symptoms of Sanhupung, and the symptoms complained by Sanhupung patients were common in the order of arthralgia, coldness, feelings like wind coming in and muscle pain. For the treatment of Sanhupung, 94.8% of the respondents used herbal medicine, followed by acupuncture 78.1%, moxibustion 50.1%, cupping 29.5%, and Chuna 12.6%. For the prevention of Sanhupung, 81.8% of the respondents prescribed herbal medicine, and 66.4% of the respondents provided education to prevent Sanhupung. Conclusions: We researched the characteristics of Sanhupung patients visiting Korean medicine clinic and Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung and reflected them in the CPG for Sanhupung.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

General anesthesia with a transcutaneous pacemaker for a Noonan syndrome patient with advanced atrioventricular block discovered in the remote period after open-heart surgery: a case report

  • Emi Ishikawa;Makiko Shibuya;Ayako Yokoyama;Takayuki Hojo;Yukifumi Kimura;Toshiaki Fujisawa
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.2
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    • pp.111-116
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    • 2023
  • We provided general anesthesia management to a patient with advanced atrioventricular block, which was discovered in the remote period after open-heart surgery. A 21-year-old man with Noonan syndrome was scheduled to undergo excision of a median intramandibular tumor. At 2 months of age, the patient underwent endocardial repair for congenital heart disease. During our preoperative examination, an atrioventricular block was detected, which had not been previously noted. Emergency drugs were administered, and a transcutaneous pacemaker was placed. During anesthesia induction, mask ventilation was easy, and intubation was performed smoothly using a video laryngoscope. The transcutaneous pacemaker was activated in demand mode at a pacing rate of 50 cycles/min approximately throughout the anesthesia time, and the hemodynamic status remained stable. The effect of intraoperatively administered atropine was brief, lasting only a few seconds. Although body movements due to thoracoabdominal muscle spasm were observed during pacemaker activation, they did not interfere with surgery. In postoperative patients with congenital heart disease, an atrioventricular block may be identified in the remote period, and preoperative evaluation should be based on this possibility. In addition, during anesthesia management, it is important to prepare multiple measures to maintain hemodynamic status.

Diagnosis of Metastatic Undifferentiated Sarcoma by Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA) (내시경초음파 세침흡인술을 통한 전이성 미분화육종의 진단)

  • Si Young Kim;Hee Seung Lee;Moon Jae Chung;Jeong Youp Park;Seungmin Bang;Seung Woo Park;Si Young Song
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.120-124
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    • 2017
  • A-49-year-old male patient with no specific medical history was admitted to the clinic because of persistent epigastric pain radiating to back for 4 months. He had multiple parenchymal tumors in body and tail of pancreas, para-spinal muscle, and mediastinum on abdomen CT image. Cytologic examination of the pancreas which was done by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) showed adenocarcinoma, whereas histological examination of the para-spinal mass showed undifferentiated sarcoma. Histologic examination of the pancreatic mass was made through endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for accurate diagnosis, and the histologic examination of both the pancreas and posterior mediastinal mass showed the same undifferentiated sarcoma. Therefore, we reviewed the cytopathic tissue obtained from the pancreas for the first time, and it was confirmed to be similar to histologic findings in the mediastinal mass.

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Single-Dose Toxicity Study of Intramuscular Neuralgia-Pharmacopuncture Injection in Rats

  • Ji Hye Hwang
    • Journal of Pharmacopuncture
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    • v.26 no.4
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    • pp.348-356
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    • 2023
  • Objectives: Neuralgia-pharmacopuncture (NP) was recently developed as a water-soluble type of pharmacopuncture inspired by CS (care special pain)-pharmacopuncture. I aimed to evaluate the toxic response and approximate lethal dose of when NP when administered intramuscularly to Sprague Dawley rats. Methods: The experimental group was divided into the NP test substance group and the saline control group and administered at a dose of 1.0 mL/animal to the posterior thigh muscles on both sides using a 1 mL syringe; each group consisted of five males and five females. Each rat was monitored for clinical signs and changes in body weight for 14 days after a single intramuscular injection. After completing observation, necropsy findings and localized tolerance at the injection site were assessed via gross necropsy and histopathological examination. Results: No deaths occurred in the NP or control group, regardless of sex. During the observation period, no changes (such as general symptoms, weight change, or visual observation results at the time of autopsy) were judged to be due to the test substance. Histopathological examination showed no changes at the administration site judged to be caused by the test substance in either the male or female test substance administration groups. In addition, mononuclear cell infiltration of the outer membrane of the femoris muscle at the administration site was observed at the same frequency and extent in the control and NP groups, and was judged to be caused by physical stimulation by the injection needle; therefore, it had no toxicological significance. Conclusion: Based on the above results, the approximate lethal dose for a single intramuscular administration of the test substance NP in Sprague-Dawley rats was judged to be > 1.0 mL/animal, and there were no findings that were judged to be due to the test substance at the administration site.

Analysis of Factors Associated with Daytime Sleepiness in Korean Adolescents (대한민국 청소년의 주간 졸음증에 관련된 요인 분석)

  • Eun Jeong Jang;Jung Sun Kim;Kitai Kim;Hye Sun Gwak;Ji Min Han
    • Korean Journal of Clinical Pharmacy
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    • v.34 no.1
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    • pp.21-29
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    • 2024
  • Background: Daytime sleepiness, a common phenomenon among adolescents focused on academics, has negative effects on aspects such as growth and overall learning. However, research on various drugs and diseases affecting daytime sleepiness is lacking in the reality. Therefore, this study aims to investigate the factors influencing daytime sleepiness in adolescents with daytime sleepiness. Methods: This study was conducted through a survey of 2,432 middle and high school students, aged 14 to 19. The questionnaire consisted of information on socio-demographic characteristics, overall health status, and sleep patterns. The Pediatric Daytime Sleepiness Scale (PDSS), translated into Korean, was used to assess daytime sleepiness. Daytime sleepiness was measured by calculating the total score for each item of the PDSS, and divided into two groups based on the cutoff value of 19, which was the upper quartile. Results: We analyzed a total of 1,770 students including 799 boys and 971 girls. Students with a PDSS score of 19 or higher made up 33.3% of boys and 66.7% of girls. In multivariate analyses, females, smoking, poor self-reported health level, sleep after 12 am, not feeling refreshed in the morning, headache, muscle pain, and scoliosis increased the risk of daytime sleepiness significantly. The AUROC of PDSS, including significant factors in multivariate analyses, was 0.751 (95% CI 0.725~0.776). Conclusions: Daytime sleepiness in adolescents affects growth, academic performance, and emotional stability. Therefore, it is important to manage medications, diseases, and other factors that affect daytime sleepiness on a social level.

Recent Domestic and International Clinical Research Trends in Gua Sha Therapy: A Scoping Review (괄사요법의 국내외 최신 임상 연구 동향: 주제범위 문헌고찰)

  • Seungwon Jung;Seungkwan Choi;Jungho Jo;Yunhee Han;Hyeonjun Woo;Byeonghyeon Jeon;Wonbae Ha;Junghan Lee
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.1
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    • pp.23-38
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    • 2024
  • Objectives This study examined recent domestic and international clinical research trends in Gua sha therapy to suggest future direction for research. Methods We used six domestic and international databases (Research Information Sharing Service, Korean studies Information Service System, Oriental Medicine Advanced Searching Integrated System, PubMed, Embase, Cochrane Library) to select clinical studies with an original text in English or Korean published after 2018. Results Finally, 55 studies were selected. Randomized controlled trials accounted for the largest amount with 42 studies. Instrument assisted soft tissue mobilization was the most frequent term referring to Gua sha. Muscle shortening, limited range of motion, and plantar fasciitis were the most common symptoms, with six cases each. Additionally, there were two studies targeting symptoms other than the musculoskeletal system. Conclusions Additional research is needed on the effects of Gua sha therapy on the back of the lower extremities and hip joints, and research is needed on the possibility of their clinical use for diseases or symptoms other than those of the musculoskeletal system. And standards for the terminology of Gua sha and the types and methods of applied interventions are needed.