The Prevalence and Ergonomic Analysis of Cumulative Trauma Disorders in the Bank Worker and Post Officer

OBJECTIVE: To survey the prevalence of Cumulative trauma disorders (CTDs) and to analyze the ergonomic factors among the bank workers and post officers. METHOD: Seventy seven subjects were collected from bank workers (50) and post officers (27) from the multiple areas of country who had been exposed to risky working environment regarding CTDs. The subjects were first screened by occupational medicine specialists and confirmed by rehabilitation medicine specialist. The serologic test, radiologic imaging, electrodiagnostic study were performed in all the subjects. Ergonomists analyzed the job element to identify the risk factors by baseline checklist of CTDs. RESULTS: Among bank workers, 30 (60%) of 50 were confirmed as having CTDs. MPS was present in 30 patients (60%), latenl epicondylitis in 5 (10%), medial epicondylitis in 3 (6.0%), tendinitis 3 (6.0%), and other disease in 3 (6.0%). Among post officers, 14 (51.9%) of 27 were confirmed as having CTDs. MPS present in 10 (37.0%), cervical disc disease in 4 (14.8%), others in 4 (14.8%). The ergonomic risk score was highest 1.87 in the 'package deviding' job, and 1.82 in 'bagging to cart', 1.62 in 'initial devision'. CONCLUSION: The result would be helpful for the prevention and management of CTDs in the bank workers and post officers.

Ultrasonographic Assessment of Nonsurgical Treatment of Postburn Hypertrophic Scar

OBJECTIVE: To evaluate the effectiveness of nonsurgical treatment and to evaluate the usefulness of ultrasonographic assessment in postburn hypertrophic scar. METHODS: The subjects were twenty-seven burn patients with hypertrophic scar. Hypertrophic scars were treated by four different methods: triamcinolone acetonide injection (Group I), pressure garment application (Group II), combination treatment of triamcinolone acetonide and garment (Group III) and no treatment (Group IV). To assess the effectiveness of each treatment method, ultrasonographic measurement of scar thickness and punch biopsy of scar were done before and after treatment. RESULTS: After 4 weeks treatment, the scar thickness decreased by 14.9 9.4% in Group I, 4.7 8.4% in Group II and 20.5 13.2% in Group III. However the scar thickness increased by 10.0 13.5% in Group IV (no treatment). The pathologic findings didn't show significant change. CONCLUSION: The TA solution injection therapy and pressure garment therapy were effective methods for the treatment of the postburn hypertrophic scar, but the combinations of both therapies was more effective than each single therapy. The ultrasonography can be used as objective measure to assess effectiveness of therapy.

Ultrasonography in Adhesive Capsulitis of Shoulder

OBJECT: To find out the anatomical changes of adhesive capsulitis of the shoulder by the ultrasonography. METHOD: We examined 20 patients with a adhesive capsulitis of the shoulder. Ultrasonographic findings were analysed by a radiologist who measured the synovium thickness of anterior, posterior and axillary plane and coracohumeral ligament length of the shoulder. RESULTS: Synovium thickness of the shoulder was measured with a mean value of 1.4+/-0.3 mm in the anterior plane, 1.4+/-0.4 mm in posterior plane and 1.8+/-0.5 mm in axillary plane of the unaffected sides and a mean value of 1.7+/-0.5 mm in the anterior, 1.8+/-0.4 mm in posterior and 3.2+/-1.0 mm in axillary planes of the affected sides. Coracohumeral ligament length was measured with a mean value of 27.8+/-7.9 mm in the unaffected side and 26.3+/-8.1 mm in the affected side. CONCLUSION: The characteristic appearance of the adhesive capsulitis of the shoulder by ultrasonography was an increased synovium thickness in the axillary plane compared to the unaffected side. This study demonstrates that the ultrasonography is a valuable tool for the evaluation and follow up for the adhesive capsulitis of shoulder.

The Factors Associated with Fall in the Stroke Patients

Fall is a major threat to the stroke patients. The purpose of this study is to find out the potential risk factors for recurrent falls in the stroke patients. The subjects were sampled 20 hemiplegic fallers who experienced at least one fall at the stroke center of Hangkang Sacred Heart hospital. Balance subscale and gait scale of Tinetti was used as a screening test for referral to mobility fuction. The potential contributing factors for fall were social activity, impulsivity, congnition, motivation. These factors were correlated with falls. The authors also surveyed the places, postures of activities, and injurires from falls. The falls occurred 2.5 times average in studied subjects and is most of subjects the first fall occurred in their first month of standing and gait training. 58.3% of falls occurred indoor(33.3% in room), 29.2% at hospital, 12.5% outdoor. The activities related to fall were walking 36.8%, rising from a chair 36.8%, sitting 10.5%. Although, most(75%) of injuries were soft tissue contusions or strains, the other 25.1% of falls accompanied fractures. The femur fracture was 18.8%, and compressed spine fracture was 6.3%. The social activity was most strongly correlated with falls with high correlation coefficent of 0.72. The other factors were not significant with lower coefficient values, balance scale of 0.35, gait scale of 0.24, motivation of 0.40, congnition of 0.26, impulsivity of ?0.19. It was suggested that activity plays an important mediating risk factor for falls in the stroke patients. These data support the concept of preventive strategy for falls in the stroke patients who are at risk.

A Clinical Review of the Burn Amputee Patients

Burn patients with associated limb amputations present demanding rehabilitation problems, many of which might lead them to chronic issues. The authors studied 77 male and 9 female burn patients with amputations. Most amputations occurred with high voltage electrical burns. The fingers were the most frequent target for amputations. The most frequent site of amputation was the entrance at the right side and multiple amputation in nature. The prosthetic fittings were delayed because of burn wounds and grafts and fragile skin at the stump. Also, limited range of motion, decreased strength, hypertrophic scar contracture, heterotopic ossification and bony overgrowth were additional limiting factors. We conclude that early rehabilitation intervention would be critical to prevent complications and to improve rehabilitation outcome of burn amputee patients.