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Effect of Complex Korean Medicine Treatment on Sacral Insufficiency Fracture: A Case Report

  • Jung, Ga Hyeon;Lee, Hyun;Ryu, Hwa Yeon;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.37 no.3
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    • pp.187-192
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    • 2020
  • Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and self-reported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.

Chronic Central Post-Stroke Pain Treated with Scalp Acupuncture and Traditional Korean Medicine: A Case Report

  • Park, Jang Mi;Lee, Jae Sung;Jeong, Jae Eun;Lee, You Jung;Lee, Cham Kyul;Roh, Jeong Du;Jo, Na Young;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.277-281
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    • 2019
  • A patient with central post-stroke pain was treated for 4 weeks with scalp acupuncture and traditional Korean medicine (following a cerebral infarction in 2013). The patient presented at Chungju hospital in January 2019 with left side weakness and tingling, numbness in the left hemisphere, chronic pain and dysarthria. Initially, herbal medicine, acupuncture, pharmacupunture, indirect moxibustion, and physiotherapy were administered together with Western medicine, with no improvement in the patient's condition. On Day 5, scalp electroacupuncture (MS1, MS5, MS10, MS11) was introduced. The numbness feeling in the patient's head resolved, and the pain in his upper body decreased. Grip force difference between the left and right hand improved from 3 kg to 0-0.5 kg. Sleep disturbance was resolved after 4 weeks treatment, and his average numeric rating scale score for pain improved from an admission score of 10, to a discharge score of 5. The patient could walk unaided after treatment.

Effects of Cognitive Function on Physical Performance and Functional Activities in Persons with Chronic Hemiparetic Stroke (만성 편마비 뇌졸중 환자의 인지기능이 신체기능 수준 및 기능적 활동에 미치는 영향)

  • Na, Eun-Jin;Hwang, Su-Jin
    • PNF and Movement
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    • v.17 no.1
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    • pp.31-39
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    • 2019
  • Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

Analysis of Postural Stability and Daily Energy Expenditure to Manage Tumor Patients' Functional Expectation

  • Caliskan, Emrah;Saygi, Evrim Karadag;Gencer, Zeynep Kardelen;Kurtel, Hizir;Erol, Bulent
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.491-499
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    • 2018
  • Background: Advances in surgical techniques, implant technology, radiotherapy, and chemotherapy have increased the recovery chances of patients with bone sarcomas. Accordingly, patients' expectations on life quality have also increased, highlighting the importance of objective evaluation of the functional results of reconstruction. Methods: Thirteen patients with distal femoral endoprosthesis, who had been followed for an average of 2.9 years were evaluated. Postural stability, daily energy expenditure, muscle power, and range of motion were the four parameters analyzed in this study. The Musculoskeletal Tumor Society (MSTS) score and Toronto Extremity Salvage Score (TESS) were used to assess postoperative function and examine correlations with other parameters. Results: Patients had sedentary activities in 84% of their daily lives. They exhibited a slower speed in the walk across test and a higher sway velocity in the sit-to-stand test (p = 0.005). MSTS scores were significantly correlated with the daily energy expenditure and walking speed. Conclusions: Objective functional results acquired from various clinics will provide significant data to compare reconstruction techniques, rehabilitation protocols, and surgical techniques. In this way, it will be possible to satisfy the expectations of patients that increase in relation to enhanced recovery.

Case Study of Soyangin Patient with Delayed Encephalopathy after Carbon Monoxide Intoxication (일산화탄소 중독 지연성 뇌손상 소양인 환자 치험 1례)

  • Suhyun Kim;June Yong Park;Jong Cheon Joo
    • Journal of Sasang Constitutional Medicine
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    • v.35 no.3
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    • pp.1-11
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    • 2023
  • Objective This case report is to show the effectiveness of Sasang Constitutional Medicine treatment on the patient with delayed encephalopathy after acute carbon monoxide intoxication. Methods A 40-year-old female patient diagnosed with delayed encephalopathy after carbon monoxide poisoning 2 weeks ago before visiting our hospital. The patient suffered gait disturbance and cognitive disorder. She was identified as Soyangin and treated with Sasang constitutional Herbal Medicine(Yangkyuksanwha-tang and Hyungbangjihwang-tang). Improvement of symptoms was evaluated through Korean Version of Mini Mental Status Examination score(MMSE-K), Modified Barthel Index(MBI), Manual Muscle Testing(MMT), Range of Motion(ROM) and Hand Function Test. Results After 7 weeks of treatment, total score of MMSE-K increased from 0 to 26, the patient could walk by herself and had no trouble carrying out her daily life. Conclusions This case showed the effectiveness of Sasang constitutional medicine treatment for delayed encephalopathy after acute carbon monoxide intoxication.

Implantable Intrathecal Drug Delivery Pump in Complex Regional Pain Syndrome Patient -A case report- (복합부위통증증후군 환자에게 시행한 매몰식 펌프를 이용한 지주막하강 내 약물투입 -증례보고-)

  • Seo, Kyung Soo;Han, Kyung Ream;Kim, Sae Young;Park, Kyeong Eon;Kim, Chan
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.74-77
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    • 2009
  • Implantable intrathecal pump is one of the therapeutic options for intractable pain. A 24-year-old male with complex regional pain syndrome was suffering from right lower extremity pain. He had all modalities of treatment including spinal cord stimulator. However, his pain had been worse in the past 6 months. His visual analogue pain scale (VAS) was 8-10 and he could not sit or walk. Only opioid was thought to be effective. Then, intrathecal pump was considered. We estimated the minimal effective dose of spinal morphine before implantation. 0.3 mg of morphine was injected intrathecally as a starting dose. Dosage had been increased up to 0.8 mg in 10 days. His VAS score decreased from 8 to 5. He could sleep without pain and walk with crutch. Therefore, intrathecal pump was inserted. He could tolerate to pain. This case suggests that intrathecal morphine delivery can provide effective treatment for intractable non-malignant pain.

Correlation Analysis of Pelvic Tilt and Gait according to the Paralytic Side of Stroke Patients (뇌졸중 환자의 마비쪽에 따른 골반의 기울임과 보행의 상관관계 분석)

  • Yong Seon, Lee;Jong-Hyuk, Yun
    • Korean Journal of Applied Biomechanics
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    • v.32 no.4
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    • pp.111-120
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    • 2022
  • Objective: This study investigated the effect of pelvic tiltng according to the paralytic side on gait in stroke patients during a 10 m functional movement timed up and go (TUG) test. Method: In this study, gait parameters were measured using a gait analyzer for 20 stroke patients and their gait was analyzed during a 10 m TUG test. For statistical analysis, an independent sample t-test were performed for age, height, and weight among general characteristics of subjects and homogeneity was tested by performing a chi-square test for gender, paralysis side, period of onset, and K-MMSE score. In order to understand the relationship between each variable, Pearson correlation analysis was performed on the variables. Results: First, the right-hand paralyzed group showed correlations in cadence and gait velocity in the up and down tilt of the pelvis, and the left-hand paralyzed group showed correlations in cadence and step length in the anterior and posterior tilt of the pelvis. Second, the tilt of the pelvis was correlated with the Sit to stand, walk forward, walk backwards, turn around at the end point, sit on a chair and the total TUG time in the right hemiplegic group compared to the left hemiplegic group. Conclusion: In this study, a significant correlation was confirmed as a result of gait analysis of right-handed stroke patients divided into a right paraplegic group and a left paraplegic group. In the future, it is suggested that treatment for improving gait of stroke patients should be treated differently for the right and left paralyzed side.

Comparison of the Berg Balance and Fullerton Advanced Balance Scale for Predicting Falls in Patients With Chronic Stroke (만성 뇌졸중 환자의 낙상 예측을 위한 버그균형 척도와 플러턴 어드밴스드 균형 척도의 비교)

  • Kim, In-seop;Nam, Taek-gil;Kim, Gyoung-mo;Kim, Jun-seop;Kim, So-jeong;Kang, Jeong-ha
    • Physical Therapy Korea
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    • v.25 no.1
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    • pp.39-46
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    • 2018
  • Background: The Berg Balance Scale (BBS) and the Fullerton Advanced Balance (FAB) scale have been used to assess balance function in patients with chronic stroke. These clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate the incidence of and risk factors of falls and compare the predictive values of the BBS and FAB scale relative to fall risk in patients with stroke through receiver operating characteristic analysis. Methods: Sixty-three patients with stroke (faller=34, non-faller=29) who could walk independently for 10 meters participated in this study. The BBS and FAB scale were administered. Then, we verified the cut-off score, sensitivity, specificity, and the area of under the curve. Results: In this study, the BBS and FAB scale did not predict fall risk in patients with stroke in the receiver operator characteristic curve analysis. A cut-off score of 37.5 points provided sensitivity of .47 and specificity of .35 on the BBS, and a cut-off score of 20.5 points provided sensitivity of .44 and specificity of .45 on the FAB scale. Conclusion: The BBS and FAB scale were not useful screening tools for predicting fall risk in patients with stroke in this study, but those who scored 37.5 or lower on the BBS and 20.5 or lower on the FAB scale had a high risk for falls.

The Effects of Trunk Control Ability on Balance, Gait, and Functional Performance Ability in Patients With Stroke (뇌졸중 환자의 체간 조절 수준이 균형과 보행 및 기능적 수행 능력에 미치는 영향)

  • An, Seung-Heon;Chung, Yi-Jung;Park, Sei-Yeon
    • Physical Therapy Korea
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    • v.17 no.2
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    • pp.33-42
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    • 2010
  • The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

The Effect of Home stayed Stroke Patients' gait, Valance, Activities of Daily Living, Depression in the Aerobic Walking Exercise Program. (유산소 걷기운동 프로그램이 재가 뇌졸중 환자의 보행, 균형, 일상활동 수행능력, 우울에 미치는 효과)

  • Roh, Kook-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.5 no.2
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    • pp.193-204
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    • 2002
  • This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.

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