• 제목/요약/키워드: postoperative rehabilitation

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Effects of Manual Therapy on Upper Extremity Pain after Breast Cancer Surgery: A Systematic Review and Meta-analysis

  • Kim, Sangyeop;Kim, Hyun-Joong
    • Physical Therapy Rehabilitation Science
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    • 제10권3호
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    • pp.343-350
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    • 2021
  • Objective: The most common type of cancer in women is breast cancer, and pain in the upper extremity and trunk is a discomfort experienced by more than half. Based on the evidence that manual therapy is effective for pain control in postoperative rehabilitation, this study aims to analyze the effects of manual therapy on upper extremity pain and function in patients after breast cancer surgery. Design: A systematic review and meta-analysis. Methods: We searched MEDLINE, Embase, PEDro, and CINAHL databases until August 2021. We included randomized controlled trial evaluating pain and function in patients after breast cancer surgery. Qualitative analysis was performed using Cochrane's risk of bias tool, and quantitative analysis was performed using RevMan 5.4 to analyze post-intervention outcomes. Results: Four randomized controlled trials were selected to evaluate the effects of upper extremity pain and function in 133 patients who underwent manual therapy after breast cancer surgery. In the results of qualitative and quantitative analysis, the experimental group treated with manual therapy showed a significant improvement in pain compared to the control group (-0.62; 95% confidence interval (CI) -0.97 to -0.27). However, there was no significant improvement in upper extremity function (-0.09; 95% CI -0.43 to 0.25). Conclusions: Current evidence shows that manual therapy is effective for pain control in patients who complain of upper extremity pain after breast cancer surgery.

전방십자인대 재건술의 합병증 (Complications of Anterior Cruciate Ligament Reconstruction)

  • 송은규;김종석
    • 대한정형외과스포츠의학회지
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    • 제2권1호
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    • pp.15-19
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    • 2003
  • Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

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족관절 골절 형태에 따른 조기 재활의 임상결과 (Clinical Outcome after Early Rehabilitation according to Injury Type in Ankle Fracture)

  • 송중원;이호승;서상교;류창현
    • 대한족부족관절학회지
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    • 제21권1호
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    • pp.21-26
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    • 2017
  • Purpose: To evaluate the clinical outcome of an operation with early rehabilitation from ankle fracture in accordance with the injury type. Materials and Methods: A total of 136 patients (70 males and 66 females) who underwent surgery and early rehabilitation for ankle fractures between December 2008 and December 2013 were retrospectively reviewed. The average age was 47.9 years, with a range of 18~79 years. The mean follow-up period was 28.7 months, with a range of 24~102 months. All patients were classified in accordance with the Lauge Hansen classification and anatomic fracture site. Moreover, the presence of ligament injuries were documented. A short-leg cast was applied postoperatively for two weeks; thereafter, patients began the range-of-motion exercises after cast removal. Full weightbearing was allowed at 2 weeks postoperatively. Each patient was assessed radiologically and clinically based on the OlerudMolander score, visual analogue scale (VAS) for pain, joint stiffness, and capability of single heel raising. Results: Seventeen patients (12.5%) complained of postoperative pain (VAS score 1~3), and the incidence was higher in patients with trimalleolar fractures or associated ligament injuries. Twenty-three patients (16.9%) complained of postoperative ankle stiffness. The mean Olerud-Molander score was 75.4/80 (range, 55~80). Olerud-Molander scores were lower in patients with ligament injuries than in those with fracture alone. There was no nonunion or fracture displacement even after early weightbearing walking. Conclusion: In this retrospective series, early rehabilitation after surgical restoration of ankle mortise by anatomical reduction and stabilization was shown to be successful. Earlier motion exercise and weightbearing walking can minimize fracture complications like joint stiffness or weakness in ankle fracture.

Maxillary resection for cancer, zygomatic implants insertion, and palatal repair as single-stage procedure: report of three cases

  • Salvatori, Pietro;Mincione, Antonio;Rizzi, Lucio;Costantini, Fabrizio;Bianchi, Alessandro;Grecchi, Emma;Garagiola, Umberto;Grecchi, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제39권
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    • pp.13.1-13.8
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    • 2017
  • Background: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. Cases presentation: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. Conclusions: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

Effects of Electrical Muscle Stimulation for Preventing Deltoid Muscle Atrophy after Rotator Cuff Repair: Preliminary Results of a Prospective, Randomized, Single-blind Trial

  • Lee, Goo Joo;Cho, Hangyeol;Ahn, Byung-Hyun;Jeong, Ho-Seung
    • Clinics in Shoulder and Elbow
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    • 제22권4호
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    • pp.195-202
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    • 2019
  • Background: This study investigates the effects of neuromuscular electrical stimulation (NMES) in preventing deltoid atrophy during the first 12 weeks after arthroscopic rotator cuff repair. Methods: Eighteen patients undergoing arthroscopic repair of a medium-sized rotator cuff tear by a single surgeon, were randomized into two groups: NMES and transcutaneous electrical nerve stimulation (TENS). Each group used the respective device for 6 weeks after surgery. Pain was measured at baseline, 6, and 12 weeks postoperatively, using the visual analogue scale (VAS); range of motion (ROM), abduction strength and functional scores were measured at baseline and 12 weeks postoperatively. Deltoid thickness and cross-sectional areas were measured using magnetic resonance imaging at 12 weeks postoperatively. Results: At 12 weeks post-surgery, no statistically significant difference was observed between the NMES and TENS groups in the pain VAS, the Disabilities of the Arm, Shoulder and Hand score, ROM, and abduction strength. Postoperative decrease in the thickness of the anterior, middle, and posterior deltoid, at the level just below the coracoid, was -2.5%, -0.7%, and -6.8%, respectively, in the NMES group, and -14.0%, -2.6%, and -8.2%, respectively, in the TENS group (p=0.016, p=0.677, and p=0.791, respectively). At the level of the inferior glenoid tubercle, postoperative decrease in area of the deltoid was -5.4% in the NMES group and -14.0% in the TENS group, which was significantly different (p=0.045). Conclusions: NMES has the potential for reducing deltoid atrophy after arthroscopic rotator cuff repair, suggesting that NMES might help minimize postoperative atrophy after various shoulder surgeries.

관상동맥 우회술(CABG)환자의 심장재활에 대한 지식과 교육 요구도 조사 (Knowledge and Learning Needs of Coronary Artery Bypass Graft Patients on Cardiac Rehabilitation)

  • 이정숙;최명애
    • Journal of Korean Biological Nursing Science
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    • 제9권1호
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    • pp.5-31
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    • 2007
  • Purpose: The purpose of this study was to explore the knowledge and learning needs on cardiac rehabilitation of coronary artery bypass graft(CABG) patients. Method: The subjects consisted of 100 CABG patients at A hospital in Seoul. Data were collected by the two different kind of questionnaires which measure knowledge and learning needs on cardiac rehabilitation of CABG patients. The subjects responded the questionnaire on knowledge before CABG and that on learning needs before their discharge. Result: The mean score of knowledge on cardiac rehabilitation was 68.54. Knowledge on risk factor, nature of disease, diet, daily activity, medication, post operative care were great in order. The mean score of learning needs on cardiac rehabilitation was 4.28. Learning needs on diet, medication, nature of disease, post operative care, daily activity, risk factor were great in order. There were significant differences in knowledge according to occupation, economic status and family history(p=.021, p=.017, p=.023). There was a positive correlation between knowledge and learning needs(r=.3009, p=.002). Conclusion: Level of knowledge on cardiac rehabilitation of CABG patients is low and knowledge on postoperative care is the lowest, and learning needs are great in ail categories.

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Bankart 병변의 관절경적 복원술 후 한방 재활치료 프로토콜을 적용하여 호전된 증례 보고 (A Rehabilitation protocol for Arthroscopic Bankart repair in Korean Medicine : A Case Report)

  • 금지혜;백동기;이정한
    • 대한한의학회지
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    • 제40권3호
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    • pp.177-187
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    • 2019
  • Objectives: The aim of this study was to report the clinical improvement of a patient who underwent arthroscopic Bankart repair using a rehabilitation protocol involving Korean medicine. Methods: The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy, and Doin exercise therapy during the admission period. To estimate the patient's status, we used the Numeric Rating Scale (NRS), Pain Disability Index (PDI), assessments of the range of motion (ROM) and Muscle Manual Test (MMT) for the shoulder joint. Results: After administering the abovementioned treatments, we found that the patient's NRS, PDI, and ROM and MMT for the shoulder joint were improved. Conclusions: The rehabilitation protocol involving Korean medicine can be applied to and produce good results for patients who undergo arthroscopic repair for Bankart lesions. The limitation of the study was that the number of cases we studied was insufficient to prove the effectiveness. Hence, further studies are needed for designing the rehabilitation protocol involving Korean medicine.

수부 감염에 대한 물리치료와 작업치료 (Physical therapy and Occupational therapy on the hand infections)

  • 정석;김정자
    • 대한물리치료과학회지
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    • 제6권1호
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    • pp.861-877
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    • 1999
  • The hand is a very specialized organ that functions to obtain information and to execute motor acts essential to human interaction with the environment. Loss of hand function through infections affects the mechanical tasks that the hand performs and psychological adjustments to their disability. Infection is a disastrous complication of hand injuries and adequacy of circulation is of greatest importance to prevention of infection. Careful debridement, incision, and adequate drainage and antibacterial treatment are of great importance. Optimal care of the infected hand demands that carefully surgical care, early postoperative exercises and other therapy. Hand rehabilitation has grown as a specialty area of both physical and occupational therapy. It is essential that the surgeon and therapist work together, and communicate freely-all of which generally require daily contact. Treating the psychological loss suffered by the patient with a hand infections is an integral part of the rehabilitation therapy as well. Treatment techniques, Whether thermal modalities or specifically designed exercises, are used as a bridge to reach a further goal of returning to functional performance.

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전방경유 경추간판 제거 및 유합술 시행 환자에 대한 추나 치료를 포함한 한의학적 치료 치험 1예 (The Case Report of Korean Medical Treatment including Chuna on Post-operative State of Cervical Spine)

  • 조동찬
    • 한방재활의학과학회지
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    • 제29권1호
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    • pp.85-90
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    • 2019
  • The purpose of this study is to report the effects of korean medical treatment including chuna after cervical surgery. We used acupuncture, chuna manual therapy, herbal medication on this patient and measured neck disability index (NDI) score, numerical rating scale (NRS) and cervical range of motion (ROM) to evaluate the treatment effects. Patient's NDI score and neck and upper extremity pain NRS were decreased and cervical ROM was increased.