뇌졸중 환자의 일상생활 및 인지기능 회복에 대한 의·한의 협진 재활치료의 효과

문소리 ( Sori Moon ),금동호 ( Dongho Keum ) 한방재활의학과학회 2020 한방재활의학과학회지 Vol.30 No.2

Objectives This study was conducted to verify the effectiveness of east-west integrative rehabilitation therapy on activity of daily living and cognitive functional recovery in stroke patients by comparing with integrative rehabilitation therapy group and conventional rehabilitation therapy group in a single institution. Methods The medical records of 106 stroke patients hospitalized in Department of Rehabilitation Medicine, Dongguk University Bundang Oriental Hospital from January 1, 2017 to February 28, 2019 were reviewed. After screening and dividing it into conventional rehabilitation (CR) group and integrative rehabilitation (IR) group, Korean version of Modified Barthel Index (K-MBI), functional independence measure (FIM), clinical dementia rating-sum of boxes (CDR-SB) were statistically analyzed. Results IR group showed significant improvement in K-MBI, FIM, and CDR-SB after treatment (p<0.001) and there was a statistically significant difference in K-MBI and CDR-SB score changes than CR group (p<0.05). And chronic patient of IR group showed significant improvement in K-MBI, FIM, and CDR-SB after treatment (p<0.01) and there was a statistically significant difference in CDR-SB score changes than CR group (p<0.05). In particular, the earlier the treatment initiation time, the more the improvement in function and when the treatment started within 2 years from the onset and patients took acupuncture and pulsed electromagnetic therapy, all scales significantly improved (p<0.001). Conclusions IR showed more improvement on activities of daily life and cognitive functional recovery than CR in this study. (J Korean Med Rehabil 2020;30(2):105-123)

경침 자가 운동 프로그램을 병행한 침 치료가 경추 만곡도와 심부 굴곡근 근력 변화에 미치는 영향

권정국 ( Jeonggook Kwon ),금동호 ( Dongho Keum ) 대한한의학회 한방재활의학과학회 2017 한방재활의학과학회지 Vol.27 No.1

Objectives This study was designed to identify the effect of acupuncture combined with wooden neck pillow self-exercise program (WSP). Methods 25 eligible subjects with chronic neck pain were recruited from September 2015 to August 2016. Subjects were treated by acupuncture twice a week for 4 weeks, also were educated WSP and exercised every day for 4 weeks. They were assessed using PI-NRS, NDI and the maximum muscle strength of deep cervical flexor muscles (DCF) before and after treatment. Also the Cobb`s angle (C1-C7), Ishihara index, Park method were assessed for evaluating the radiographical changes. Variables were compared using paired t-test. And correlates analysis was used for analyzing relationship between differentials in the maximum muscle strength of DCF and differentials in cervical spine curvature measurement methods. Results Among the 25 subjects, 4 subjects were lost to follow-up or excluded in accordance with the criteria. Significant differences on NRS, NDI and the maximum muscle strength of DCF were seen after treatment (p<0.001). In radiological finding, cervical spine curvature measurement methods were significantly increased (p<0.001, p<0.05, p <0.05). Differentials in the maximum muscle strength of DCF significantly correlates to differentials in Ishihara index (R=0.479, p<0.05). Conclusions Acupuncture combined with WSP may decrease neck pain intensity and associated disability, and also increase the muscle strength of DCF and cervical lordosis, in patients with chronic neck pain. Especially, Improving the muscle strength of DCF has a relationship with improving Ishihara index. However, due to the design of this study, this treatment can not be compared with other treatments. Future randomized project should be needed. (J Korean Med Rehabil 2017;27(1):37-51)

미주신경 감각분지 분포영역의 자침이 자율신경 변화에 미치는 영향

안선주 ( Sunjoo An ),금동호 ( Dongho Keum ) 한방재활의학과학회 2021 한방재활의학과학회지 Vol.31 No.2

Objectives This study was designed to identify the changes of autonomic nervous system (ANS) which was induced by acupuncture at the field of the auricular branch of the vagus nerve. Methods 30 healthy adults were selected and classified into two groups; experimental group, control group. After providing mental stress, acupuncture was applied at external ear in experimental group and no treatment executed in control group. The evaluation of ANS function was measured by heart rate variability (HRV). We statically analyzed the difference of HRV parameters which include mean heart rate (MHRT), standard deviation of all N-N intervals (SDNN), square root of the mean of the sum of the squares of differences between adjacent N-N intervals (RMSSD), total power (TP), low frequency power (LF), high frequency power (HF), LF/HF ratio. Results All subjects showed significant increase in SDNN, LF after stress stimulation (p<0.05). Immediately after intervention, MHRT was significantly decreased (p<0.001) and RMSSD, HF were significantly increased in experimental group (p<0.05). After the end of intervention, SDNN, HF, RMSSD, TP, LF were significantly increased in experimental group (p<0.01, p<0.05). And when comparing baseline HRV, SDNN, LF were significantly increased in control group (p<0.01) and SDNN, RMSSD, TP, LF were significantly increased in experimental group (p<0.05). In the subgroup analysis, normal balance of ANS group showed significant increase in TP, LF, SDNN, HF (p<0.01, p<0.05). Conclusions We suggested that acupuncture at external ear, region of the vagus nerve distribution could increase parasympathetic activity and cause changes and reregulation of the ANS. (J Korean Med Rehabil 2021;31(2):81-97)

Symptomatic Schmorl's Node로 인한 요통과 비신경근성 하지통을 호소하는 환자에 대한 보존적 치료 치험 2예: 증례보고 및 문헌고찰

강신우 ( Shinwoo Kang ),박서현 ( Seohyun Park ),금동호 ( Dongho Keum ),최성환 ( Seonghwan Choi ),박현선 ( Hyeonsun Park ) 한방재활의학과학회 2022 한방재활의학과학회지 Vol.32 No.1

The objective was to propose effectiveness of conservative treatments including Korean medical treatments for symptomatic Schmorl's nodes (SNs). We conducted retrospective study that analyzed the medical records of two patients with the symptomatic SNs. They were treated by conservative treatments including Korean medical treatments for 3 weeks. We evaluated numeric rating scale (NRS), Oswestry disability index (ODI) and EuroQol-5 dimension (EQ-5D) index. After treatment, NRS, ODI were decreased and EQ-5D index was increased. We performed literature search to analyze the mechanisms of its treatment and evaluate clinical trials. There were three major mechanisms: (1) Improving constructive stability of vertebrae, (2) alleviating pain, and (3) controlling autoimmunity. When comparing operative treatment (OT) trials and conservative treatment (CT) trials, we couldn't find conclusive basis that support which one is more effective. As OT trials reported some severe adverse events, CT trials reported mild adverse events. The conservative treatments that we used encompasses those mechanisms and is relatively safe. To obtain exact evidence of effectiveness, further studies are needed. (J Korean Med Rehabil 2022;32(1):133-144)

말초성 안면마비 후유증 환자에서 침 치료와 바깥목동맥으로의 분지 영역에 시행한 고주파 병행 치료의 안면부종 감소 효과: 증례보고

안선주 ( Sunjoo An ),최성환 ( Seonghwan Choi ),강신우 ( Shinwoo Kang ),박서현 ( Seohyun Park ),금동호 ( Dongho Keum ) 한방재활의학과학회 2020 한방재활의학과학회지 Vol.30 No.4

This study was performed to evaluate the effect of high frequency therapy applied to the region branching to the external carotid artery for peripheral facial paralysis sequelae. A patient suffering with facial edema due to facial paralysis sequelae had been treated with acupuncture, high frequency therapy on the branch area to the external carotid artery for 7 weeks. The evaluation of clinical outcome was done by degree of swelling by measuring the distance of the face and skin temperature of face through digital infrared thermographic imaging. After treatment, the patient's degree of swelling and the temperature difference between the affected side and normal side was decreased. In addition, the temperature was changed in the entire facial area as well as the treatment point of high frequency therapy. This result shows that acupuncture combined with high frequency therapy at the region branching to the external carotid artery could be an effective way to improve facial blood flow, although further clinical studies will be needed. (J Korean Med Rehabil 2020;30(4):233-241)

전침 및 봉약침 치료로 호전된 특발성 말초신경병증의 증례보고

안선주 ( Sunjoo An ),최성환 ( Seonghwan Choi ),강신우 ( Shinwoo Kang ),박서현 ( Seohyun Park ),금동호 ( Dongho Keum ) 한방재활의학과학회 2020 한방재활의학과학회지 Vol.30 No.2

The purpose of this study is to report the effects of electroacupuncture and bee venom (BV) acupuncture for a patient suffering with idiopathic peripheral neuropathy. There was a one patient who was diagnosed as idiopathic peroneal neuropathy and tibial neuropathy received electroacupuncture and BV acupuncture at acupoints on peroneal and tibial nerve pathway. The evaluation of clinical outcome was done by range of motion (ROM), manual muscle test (MMT), perimeter of lower leg, neuropathy pain scale (NPS). After treatment, the patient showed improvement in ROM and MMT. The patient’s perimeter of lower leg was increased, NPS was decreased. This study suggests that the treatment of acupoints on the damaged nerve pathways could be an effective treatment for peripheral neuropathy, although further studies will be needed. (J Korean Med Rehabil 2020;30(2):173-181)

한의 치료로 호전된 경추성 현훈 환자 치험 3예

최성환 ( Seonghwan Choi ),강신우 ( Shinwoo Kang ),박현선 ( Hyeonsun Park ),박서현 ( Seohyun Park ),금동호 ( Dongho Keum ) 한방재활의학과학회 2022 한방재활의학과학회지 Vol.32 No.1

The purpose of this study is to evaluate the effectiveness of traditional Korean medicine treatment of cervical vertigo. Three patients were diagnosed as cervical vertigo with correlating symptoms of imbalance and dizziness with neck pain. The diagnosis of cervical vertigo is also dependent on excluding other vestibular disorders on the basis of history, examination, and vestibular function tests. They were treated by acupuncture, transcutaneous electrical nerve stimulation therapy and low-intensity pulsed ultrasound at acupoints and sympathetic ganglion chain of their cervical and upper thoracic region. The evaluation of clinical outcome was done by numeric rating scale (NRS), dizziness handicap inventory (DHI) and neck disability index (NDI), EuroQol-five dimensions questionnaire (EQ-5D) index. After the treatment, the value of their NRS, NDI, DHI was significantly decreased and their EQ-5D index was significantly increased. The traditional Korean medicine treatment at cervical and upper thoracic region could be an effective way to treat cervical vertigo. (J Korean Med Rehabil 2022;32(1):145-155)

침치료 후 근건이완수기요법을 적용한 주관절 외상과염 환자치험 3례

박재원 ( Jaewon Park ),박서현 ( Seohyun Park ),문소리 ( Sori Moon ),송미영 ( Miyoung Song ),금동호 ( Dongho Keum ) 대한한의학회 한방재활의학과학회 2017 한방재활의학과학회지 Vol.27 No.2

We researched 3 patients diagnosed as Lateral epicondylitis (Tennis elbow). We considered it as tendinosis including irregular collagen fiber`s pattern. So, acupuncture therapy and musculotendinous releasing manual therapy were used to treat the patients. We measured their pain and functional disorder by visual analogue scale (VAS), Patient-Rated Tennis Elbow Evaluation (PRTEE), and a dynamometer before and after treatment. As a result, VAS and PRTEE significantly reduced and grasping power was also improved. Therefore, we conclude that the acupuncture therapy with musculotendinous releasing manual therapy is an effective way to treat Lateral epicondylitis. But there are limits on this study due to insufficient number of cases, absence of control group and absence of follow-up after last treatment. Further studies will be needed. (J Korean Med Rehabil 2017;27(2):101-108)

경추부 중심의 침치료로 호전된 비정형 안면통의 치험 2례

박서현 ( Seohyun Park ),문소리 ( Sori Moon ),안선주 ( Sunjoo An ),금동호 ( Dongho Keum ) 대한한의학회 한방재활의학과학회 2018 한방재활의학과학회지 Vol.28 No.2

Atypical facial pain is persistent facial pain in the absence of clinical neurological deficit. We experienced two patient who are diagnosed atypical facial pain with Classification of International Headache Society. They were treated by acupuncture at their cervical and facial region. After treatment, their Pain intensity numerical rating scale(PI-NRS) is decreased and EuroQol five dimensions questionnaire(EQ-5D) score is increased. Treatment of acupuncture at cervical and facial region could be effective for easing the clinical symptoms of atypical facial pain. Further studies are needed to find effective treatment for atypical facial pain. (J Korean Med Rehabil 2018;28(2):121-126)

한방병원에 내원한 척추측만증 환자의 특성에 대한 후향적 연구

강신우 ( Shinwoo Kang ),박현선 ( Hyunsun Park ),박서현 ( Seohyun Park ),성원석 ( Wonsuk Sung ),김은정 ( Eunjung Kim ),금동호 ( Dongho Keum ) 한방재활의학과학회 2022 한방재활의학과학회지 Vol.32 No.1

Objectives This study was conducted to characterize scoliosis patients visiting Korean medicine hospital and to analyze the demands and factors affecting discomfort. Methods This retrospective study analyzed 33 scoliosis patients who visited Korean medicine hospital from March, 2021 to October, 2021. The data analysis consisted of three factors: (1) demographic characteristics, (2) characteristics of demands on Korean medicine (reasons for choosing Korean medical treatment, preferred treatment methods, most uncomfortable part, treatment priorities) and (3) discomfort factors (treatment experiences, diagnosed age and Cobb's angle). Statistical analyses were performed and a p-value≤0.05 was considered to be statistically significant. Results 43.75% of the patients chose ‘effectiveness’ for the reason why they preferred Korean medicine treatment. ‘Chuna treatment’ was the most preferred treatment method. The patients chose ‘lower back’ for the most uncomfortable part and ‘pain’ for the highest priority of improvement. The Cobb's angle of included patients was 16.02±7.65° and it is not much differ to average of Cobb's angle in Korean. Discomfort was more severe in the patients with treatment-experienced than treatment- naive. The score of discomfort in appearance and psychological were higher in the patients diagnosed in childhood or adolescent period than who were diagnosed after adult. Classification based on Cobb's angle showed no statistical difference. Conclusions Not only Cobb's angle but also other clinical factors should be considered for effective treatment in scoliosis. Also, It is necessary to pay attention to adult scoliosis patients. (J Korean Med Rehabil 2022;32(1):63-72)