• 제목/요약/키워드: whiplash

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최근 10년간 교통사고 환자의 추나치료에 대한 국내 연구 동향 (Trends of Chuna Manual Therapy on Traffic Accident in Korea from 2005 to 2014)

  • 전용태;박상훈;한국인;이정한;고연석
    • 한방재활의학과학회지
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    • 제25권2호
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    • pp.89-96
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    • 2015
  • Objectives This study is to investigate domestic trends of chuna manual therapy on traffic accident for recent 10 years. Methods We searched the studies on chuna manual therapy for traffic accident in 6 Korean web databases. Consequently, 17 research papers were founded. We analyzed these papers according to their published year, the titles of journal, the type of study, the number of cases, the sites of injury, assessment scales of study, and ethics of research. Results 17 papers were published since 2005. The studies on chuna manual therapy about traffic accident were mainly published in the journal of korean society of chuna manual medicine for spine & nerves and the journal of korean medicine rehabilitation. All papers were clinical research include 2 case series, 2 non randomized controlled trials (NRCTs), 13 randomized controlled trials (RCTs). The most frequently occured symptom was neck pain. In assessment scales, visual analog scale (VAS) was mainly used. All clinical studies were not mentioned about approval of institutional review board (IRB). Conclusions In this study, we analyzed the trends of chuna manual therapy on traffic accident in Korea from 2005 to 2014. In reviewing published papers, we found several weak points in methods of research and quality of study protocol. It is needed to adjust these problems for development of future researches.

국내 교통사고 후유증의 침치료에 대한 체계적 문헌고찰 (Acupuncture for Rehabilitation in Patients with Traffic Accident in South Korea: a Systematic Review)

  • 김건형;남동우;강중원;이재동;최도영
    • Journal of Acupuncture Research
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    • 제27권1호
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    • pp.21-29
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    • 2010
  • Objectives : This study aims to evaluate current clinical evidence of acupuncture treatment for rehabilitation in patients with traffic accident in South Korea. Methods : Seven Korean databases were searched for prospective clinical trials for acupuncture on rehabilitation in patients with traffic accident from their inception to June, 2009. Only studies conducted in Korean language were searched. Risk of bias in included randomized controlled trials were assessed by Cochrane Handbook procedure. Results : Fifteen clinical trials were included among 31 studies searched. Eight were observational studies, five were non-randomizedcontrolled trials, and two were randomized controlled trials. In all of included studies, acupuncture were conducted with other concomitant treatment. Included studies dealt with such conditions as neck pain, low back pain tinnitus after traffic accident, post-traumatic stress, oculomotor nerve palsy, diplopia and insomnia. All of included studies reported favorable effects of acupuncture group compared to baseline or control group. All of included studies lacked the occurrence of adverse events. High risk of bias were observed in two randomized controlled trials. Conclusions : There is no evidence that acupuncture is effective for rehabilitation of traffic accident. All of included studies lacked appropriate methodological qualities and internal validity. Future welldesigned clinical trials that evaluate the effects and safety of acupuncture treatment for rehabilitation in patients with traffic accident is needed.

교통사고 후 발생한 경항통에 대한 황련해독탕약침, 봉독약침, 중성어혈약침 치료의 효과 비교 연구: 후향적 관찰 연구 (Comparative Effectiveness of Hwangryunhaedok-tang Pharmacopuncture, Essential Bee Venom Pharmacopuncture and Jungsongouhyul Pharmacopuncture for Cervical Pain caused by Traffic Accidents: A Retrospective Observational Study)

  • 김영준;김태령;우창훈;신병철
    • 한방재활의학과학회지
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    • 제28권2호
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    • pp.83-89
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    • 2018
  • Objectives The purpose of this study is to compare the effectiveness of Hwangryunhaedok-tang Pharmacopuncture, Bee Venom Pharmacopuncture and Jungsongouhyul Pharmacopuncture on cervical pain caused by traffic accident retrospectively. Methods The retrospective observational chart review was conducted to 52 cases of traffic accident patients who had admitted to Daegu haany University Pohang Korean Hospital from December 1st, 2015 to May 31th, 2017. The patients were classified into three groups by which pharmacopuncture was used as Hwangryunhaedoktang pharmacopuncture treatment group, bee venom pharmacopuncture treatment group and Jungsongouhyul pharmacopuncture treatment group. Additionally, outcomes should include Neck disability index(NDI) and patient's global assessment(PGA) for evaluate the treatment effects. Results Each pharmacopuncture treatment group showed significant decrease of NDI and PGA. But there was no significant difference in NDI and PGA between three groups. Conclusions According to the results, we found out that 3 kinds of pharmacopunctures are considered to be effective and useful for cervical pain patients caused by traffic injury. Further well designed prospective studies are needed.

전신증상을 동반한 교통사고 입원환자에 대한 한방자동차보험 진료와 산삼비만약침 병행 치료: 환자군 연구 (Synergistic Effect of Wild Ginseng Complex Pharmacopuncture Combined with Korean Medicine Automobile Insurance Treatment on Two Obese Inpatients with Systemic Symptoms: Case Series)

  • 김덕현;강미숙;송호섭;황지혜
    • Korean Journal of Acupuncture
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    • 제36권1호
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    • pp.81-91
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    • 2019
  • Objectives : Symptoms caused by traffic accidents can be divided into localized pain and systemic symptoms. Edema and pain can be increased due to obesity. During hospitalization of obese patients after traffic accident injury, obesity and systemic symptoms such as edema, dizziness, abdominal fullness and heavy body feeling might increase more by decreased physical activity due to pain. Methods : This report details on two cases of obese female inpatients with systemic symptoms after a car accident who were treated with wild ginseng complex (WGC) pharmacopuncture combined with Korean Medicine (KM) automobile insurance treatment. The Numeric Rating Scale (NRS), Neck Disablility Index (NDI) and the Oswestry Disablility Index (ODI) were evaluated before and after treatment for comparison. Body composition was also measured. Results : Localized pain improved with a decrease in patients' NRS, NDI and ODI scores. Systemic symptoms increased during hospitalization were also improved with changes of body composition. Conclusions : Combining WGC pharmacopuncture with KM automobile insurance treatment may be synergistically effective for the treatment of obese patients with systemic symptoms such as edema, heavy body feeling and abdominal fullness.

전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告)) (Total Spinal Block and Cortical Epidural Block for Whiplash Syndrome and Reflex Sympathetic Dystrophy (Report of Four Cases))

  • 박오;옥시영;송후빈
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.106-119
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    • 1988
  • For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

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탑승자 교통사고에서 경추손상 판단을 위한 중증도 요인 분석 (Parameter Analysis to Predict Cervical Spine Injury on Motor Vehicle Accidents)

  • 이희영;육현;공준석;강찬영;성실;이정훈;김호중;김상철;추연일;전혁진;박종찬;최지훈;이강현
    • 자동차안전학회지
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    • 제10권3호
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    • pp.20-26
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    • 2018
  • It was a pilot study for developing an algorithm to determine the presence or absence of cervical spine injury by analyzing the severity factor of the patients in motor vehicle occupant accidents. From August 2012 to October 2016, we used the KIDAS database, called as Korean In-Depth Accident Study database, collected from three regional emergency centers. We analyzed the general characteristics with several factors. Moreover, cervical spine injury patients were divided into two groups: Group 1 for from Quebec Task Force (hereinafter 'QTF') grade 0 to 1, and group 2 for from QTF grade 2 to 4. The score was assigned according to the distribution ratio of cervical spine injured patients compared to the total injured patients, and the cut-off value was derived from the total score by summation of the assigned score of each factors. 987 patients (53.0%) had no cervical spine injuries and 874 patients (47.0%) had cervical spine injuries. QTF grade 2 was found in 171 patients (9.2%) with musculoskeletal pain, QTF grade 3 was found in 38 patients (2.0%) with spinal cord injuries, and QTF grade 4 was found in 119 patients (6.4%) with dislocation or fracture, respectively. We selected the statistically significant factors, which could be affected the cervical spine injury, like the collision direction, the seating position, the deformation extent, the vehicle type and the frontal airbag deployment. Total score, summation of the assigned each factors, 10 was presented as a cut-off value to determine the cervical spine injury. In this study, it was meaningful as a pilot study to develop algorithms by selecting limited influence factors and proposing cut-off value to determine cervical spine injury. However, since the number of data samples was too small, additional data collection and influencing factor analysis should be performed to develop a more delicate algorithm.

무인항공기 표적살인(Targeted Killing)에 관한 고찰: 논쟁과 실행 정당성을 중심으로 (A Study of Targeted Killing, Unmanned Aerial Vehicles)

  • 소재선;이창규
    • 항공우주정책ㆍ법학회지
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    • 제32권1호
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    • pp.53-81
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    • 2017
  • 우리나라에서 표적살인(Targeted Killing)은 많이 논의되지 않았지만 군사과학기술의 발전과 더불어 대(代)테러전쟁에서 핵심전략으로 떠올랐다. 표적살인 전략의 핵심요소인 무인항공기(UAV)는 조종사가 탑승하지 않은 채 원격조종으로 특정목표를 미사일로 공격할 수 있다. 이 전략은 국방예산의 절감하는 방안이면서 총력전에서 적의 수장을 제거하여 심리전에서 우위를 차지하기 위한 방안으로 주목을 받고 있다. 이에 우리나라도 한반도의 평화를 지키기 위한 전략으로서 도입을 고려할 필요가 있다. 그러나 무인항공기를 사용한 표적살인 전략은 전쟁행위인지 아니면 살인행위인지에 대한 크나큰 논란이 있다. 공격 대상인 테러리스트 등은 자신들이 공격대상이라는 사실을 알지도 못한 채 죽임을 당하기 때문에 미국 시민단체 등을 중심으로 생명의 윤리성에 대하여 문제의 제기를 하고 있다. 또한 미사일 공격으로 무고한 시민이 사망할 수 있다는 것과 자국군에 대한 오발을 행할 수도 있다는 점, 조종사가 심리적으로 겪을 수 있는 전투 스트레스 등이 주요 문제이다. 그래서 이러한 우려를 불식시키기 위해 투명성과 정당성의 확보가 필요하다. 나아가 무인항공기 표적살인 가이드라인을 제정하여 전략의 엄중한 실행과 남용을 막고 국민의 신뢰를 확보할 필요가 있다. 이러한 가이드라인에서는 미국과 같이 대통령이 단독으로 전략의 실행을 결정하는 것이 아니라 국회의 동의를 받아 실행하게 된다면 국민의 신뢰를 얻을 수 있을 것이라고 생각한다.

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교통사고 이후 디스크 탈출이 없이 상지 저림을 호소하는 환자의 경추 측굴과 상지 저림에 관한 연구 (The Study on Relation between Cervical Lateroflexion and Upper Limb Numbness of Patients without Disc Herniation after Traffic Accident)

  • 박현민;박지용;김동섭;김은수;김미령;조남훈;정훈;성익현;김민우;홍남중;하인혁;이진호
    • 척추신경추나의학회지
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    • 제8권2호
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    • pp.21-29
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    • 2013
  • Objectives : The purpose of this study is to investigate the relation between cervical spine lateroflexion and upper limb numbness after whiplash injury by traffic accident. Methods : Outpatients who visited Jaseng korean medicine hospital after traffic accident took cervical MRI. Patients who had Normal disc and bulging disc were reviewed to measure the cervical lateroflexion by C2-C7 Cobb's angle & scalenus muscle's length through neutrality AP X-ray views. For statistics, we used SPSS version 18.0 for windows. Results : Groups classified into difference of scalenus muscle's length were showen statistical significance than into cobb's angle. Means of numbness group's length difference are $4.18{\pm}2.26mm$ and that of non-numbness group is $1.59{\pm}1.17mm$. Unilateral numbness group had greater angle and longer of length's difference than non-numbness group. Conclusions : The more severe the lateroflexion of the upper extremity numbness occurs well. Group classifed into difference of scalenus muscle's length has more tendency of occurrence of upper limb numbness than that into cobb's angle. And upper limb numbness occurs more frequently at the same direction of lateroflexion.

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Appraisal of Guidelines for Research & Evaluation (AGREE) II를 이용한 교통사고 상해증후군의 국내·외 기개발 임상진료지침의 평가 (Appraisal of Guidelines for Research & Evaluation II Appraisal of Clinical Practice Guidelines for Traffic Injuries)

  • 박경원;이준석;김현태;박선영;허인;신병철
    • 한방재활의학과학회지
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    • 제31권4호
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    • pp.129-143
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    • 2021
  • Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

교통사고로 인한 어지럼 환자의 임상양상 (Clinical Characteristics of the Patients with Dizziness after Car Accidents)

  • 하영민;양철원;김상훈;여승근;박문서;변재용
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제60권8호
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    • pp.390-395
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    • 2017
  • Background and Objectives With increasing frequency of car accidents, patients of dizziness caused by car accidents are also increasing. Various types of dizziness or vertigo can occur from car accidents depending on different injury mechanisms. Since accurate diagnosis is important for providing proper treatments, we evaluated clinical characteristics related to vestibular function of patients with dizziness caused car accidents. Subjects and Method In this retrospective case review study that runs from January 2011 to March 2013, a total of 82 patients with dizziness following car accident were enrolled consecutively. We analyzed the final diagnosis of dizziness according to different mechanisms of injury during car accident through clinical record review. Patients who developed dizziness within one month of car accident were included, excluding those who had temporal bone fracture and previous history of dizziness. Results Of the different types observed, 36.6% was head injury, 24.4% whiplash injury, 3.7% complex injury, 2.4% others and the rest was unknown. In the final diagnosis, the different types included 36.6% benign paroxysmal positional vertigo (BPPV), 23.2% unclassifiable dizziness, 18.3% cervical vertigo, 7.3% labyrinthine concussion, 3.7% BPPV with labyrinthine concussion and the rest was others. Of the different types of dizziness symptoms, 58.5% was headache, 45.1% was audiologic symptoms, and others included earfullness, tinnitus and hearing disturbance. Tinitogram and pure tone audiogram results show that 2.9% (27 people) of patients have tinnitus and 7.3% (6 people) have hearing disturbance. Conclusion An accurate diagnosis and timely management would be very important in forming a proper approach for post traumatic vertigo patients.