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Cardiovascular disease (CVD) poses a significant health challenge globally, including in Korea, due to its status as a leading cause of death and its impact on cardiopulmonary function. Cardiac rehabilitation (CR) is a well-established program that not only aids in restoring cardiopulmonary function, but also improves physical and social conditions. The benefits of CR are widely recognized, and it is implemented globally. While the effectiveness of CR has been proven in Korea, it is underutilized. This fact sheet summarizes the current status of CR in Korea, including the prevalence of CVD, the clinical practice guidelines for CR programs, and the challenges of implementing CR in Korea.
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Background@#In Korea, the actual distribution of cardiac rehabilitation (CR) to the clinical field is insufficient due to the many barriers for cardiovascular patients to participate in CR. Community-based CR is a useful alternative to overcome these obstacles. Through a nationwide survey, we investigated the possibility of regional medical and public health management institutes which can be in charge of community-based CR in Korea. @*Methods@#The questionnaires on recognition of CR and current available resources in health-related institutions were developed with reference to the CR evaluation tools of York University and the International Council of Cardiovascular Prevention and Rehabilitation.The questionnaires were sent to regional public and private medical institutions and public health management institutions. @*Results@#In total, 2,267 questionnaires were sent to 1,186 institutions. There were 241 and 242 responses from 173 and 179 regional private and public medical institutions, respectively. And a total of 244 responses were gathered from 180 public health management institutions. Although many institutions were equipped with the necessary facilities for exercise training, there were few patient-monitoring systems during exercise. Most institutions were aware of the need for CR, but were burdened with the cost of establishing personnel and facilities to operate CR. @*Conclusion@#Most regional medical, and public health management institutions in Korea are unprepared for the implementation of community-based CR programs. To encourage the utilization of such, there should be efforts to establish a national consensus.
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Objective@#The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. @*Conclusion@#This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.
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Objective@#The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. @*Conclusion@#This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.
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Objective@#To test the hypothesis that a longer duration of phase II cardiac rehabilitation is required to recover the exercise capacity of elderly patients compared to younger patients. @*Methods@#We retrospectively reviewed and analyzed the medical records of patients who were referred to our cardiac rehabilitation (CR) center and underwent percutaneous coronary intervention for acute myocardial infarction (AMI). A total of 70 patients were enrolled who underwent an exercise tolerance test (ETT) 3 weeks after the occurrence of an AMI (T0), 6 weeks after the first ETT (T1), and 12 weeks after the first ETT (T2). Patients older than 65 years were assigned to the elderly group (n=24) and those aged 65 years and younger to the younger group (n=46). Both groups performed center-based or home-based CR for 12 weeks (3 times per week and 1 session per day). Exercise intensity for each individual was based on the target heart rate calculated by the Karvonen formula. The change in maximal metabolic equivalents (METmax) of the two groups was measured at each assessment point (T0, T1, and T2) to investigate the recovery of exercise capacity. @*Results@#The younger group showed improvement in METmax between T0 and T1. However, METmax of the elderly group showed no significant improvement between T0 and T1. The exercise capacity, measured with METmax, of all groups showed improvement between T0 and T2. @*Conclusion@#Elderly patients with AMI need a longer duration of CR (>6 weeks) than younger patients with AMI.
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BACKGROUND@#Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea.@*METHODS@#This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified.@*RESULTS@#CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR.@*CONCLUSION@#Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular (CV) disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of thirty-three authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers CV mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular (CV) disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of thirty-three authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers CV mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
Asunto(s)
Humanos , Síndrome Coronario Agudo , Causas de Muerte , Consultores , Enfermedad Coronaria , Atención a la Salud , Corazón , Hospitales Generales , Hospitales Universitarios , Beneficios del Seguro , Corea (Geográfico) , Estilo de Vida , Métodos , Mortalidad , Infarto del Miocardio , Nutricionistas , Fisioterapeutas , Medicina Preventiva , Recurrencia , Rehabilitación , Prevención Secundaria , Especialización , Medicina Deportiva , CirujanosRESUMEN
OBJECTIVE: To compare a center-based cardiac rehabilitation (CR) program with a home-based CR program in terms of improving obesity related index and cardiopulmonary exercise capacity after the completing a phase II CR program. METHODS: In this study, there were seventy-four patients with acute myocardial infarction after percutaneous coronary intervention who were analyzed. Patients with mild to moderate risk (ejection fraction >40%) were included in the group. The patients underwent an exercise tolerance test by measurement of the modified Bruce protocol at three assessment points. Those in the center-based CR group participated in a 4-week training program with electrocardiography monitoring of the patient’s progress and results, while those patients who were in the home-based CR group underwent self-exercise training. We measured the obesity related indices such as body mass index, fat free mass index (FFMI), and cardiopulmonary exercise capacity including peak oxygen consumption (VO(2max)), metabolic equivalents (METs), heart rate, resting systolic blood pressure and the diastolic blood pressure of the participants and noted the results. RESULTS: Of the 74 patients, 25 and 49 participated in the center-based and home-based CR programs, respectively. Both groups showed significant improvement in VO(2max) and METs at 1-month and 6-month follow-up. However, FFMI was significantly improved only in the center-based CR group after 1 month of the phase II CR. CONCLUSION: Both groups identified in the study showed significant improvement of VO(2max) and METs at 1-month and 6-month follow-up. However, there was no significant difference in the intergroup analysis. A significant improvement of FFMI was seen only in the center-based CR group after phase II CR.
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Humanos , Presión Sanguínea , Índice de Masa Corporal , Educación , Electrocardiografía , Tolerancia al Ejercicio , Estudios de Seguimiento , Frecuencia Cardíaca , Servicios de Atención de Salud a Domicilio , Equivalente Metabólico , Infarto del Miocardio , Obesidad , Consumo de Oxígeno , Intervención Coronaria Percutánea , RehabilitaciónRESUMEN
OBJECTIVE: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and three additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and two general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, three rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. PRINCIPAL CONCLUSIONS: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Humanos , Síndrome Coronario Agudo , Enfermedades Cardiovasculares , Causas de Muerte , Consultores , Enfermedad Coronaria , Atención a la Salud , Corazón , Hospitales Generales , Hospitales Universitarios , Beneficios del Seguro , Corea (Geográfico) , Estilo de Vida , Métodos , Mortalidad , Infarto del Miocardio , Nutricionistas , Fisioterapeutas , Medicina Preventiva , Recurrencia , Rehabilitación , Prevención Secundaria , Especialización , Medicina Deportiva , CirujanosRESUMEN
BACKGROUND: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. RESULTS: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. CONCLUSION: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
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Humanos , Síndrome Coronario Agudo , Enfermedades Cardiovasculares , Causas de Muerte , Consultores , Enfermedad Coronaria , Atención a la Salud , Corazón , Hospitales Generales , Hospitales Universitarios , Beneficios del Seguro , Corea (Geográfico) , Estilo de Vida , Métodos , Mortalidad , Infarto del Miocardio , Nutricionistas , Fisioterapeutas , Medicina Preventiva , Recurrencia , Rehabilitación , Prevención Secundaria , Especialización , Medicina Deportiva , CirujanosRESUMEN
OBJECTIVE: To determine whether heart rate recovery (HRR) following an exercise tolerance test (ETT) is correlated with a changing ratio of peak oxygen consumption (VO₂) and maximal metabolic equivalents (MET(max)). METHODS: A total of 60 acute myocardial infarction (AMI) patients who underwent ETT at both assessment points - 3 weeks (T0) after the AMI attack and 3 months after T0 (T1) were included. After achieving a peak workload, the treadmill was stopped with a 5-minute cooldown period, and the patients recovered in a comfortable and relaxed seated position. HRR was defined as the difference between the maximal heart rate (HR(max)) and the HR measured at specific time intervals - immediately after the cool down period (HRR-0) and 3 minutes after the completion of the ETT (HRR-3). RESULTS: HRR-0 and HRR-3 increased over time, whereas VO(2max) and METmax did not show significant changes. There was a positive correlation between HRR at T0 and the exercise capacity at T0. HRR at T0 also showed a positive correlation with the exercise capacity at T1. There was no significant correlation between HRR measured at T0 and the change in the ratio of VO(2max) and MET(max), as calculated by subtracting VO(2max) and MET(max) obtained at T0 from those obtained at T1, divided by VO(2max) at T0 and multiplied by 100. CONCLUSION: Post-exercise HRR measured at 3 weeks after the AMI onset can reflect the exercise capacity 3 months after the first ETT. However, it may be difficult to correlate post-exercise HRR at T0 with the degree of increase in cardiopulmonary exercise capacity in patients with AMI.
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Humanos , Sistema Nervioso Autónomo , Prueba de Esfuerzo , Tolerancia al Ejercicio , Frecuencia Cardíaca , Corazón , Equivalente Metabólico , Infarto del Miocardio , Consumo de Oxígeno , PosturaRESUMEN
Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.
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Femenino , Humanos , Persona de Mediana Edad , Articulación de la Cadera , Cadera , Extremidad Inferior , Músculos , Dolor Pélvico , Pelvis , Estimulación Eléctrica Transcutánea del Nervio , Puntos DisparadoresRESUMEN
OBJECTIVE: To quantify changes in cardiopulmonary function using a lower body positive pressure supported (LBPPS) treadmill during the exercise tolerance test (ETT) in healthy subjects before applying the LBPPS treadmill in patients with gait problems. METHODS: We evaluated 30 healthy subjects who were able to walk independently. The ETT was performed using the Modified Bruce Protocol (stages 1–5) at four levels (0%, 40%, 60%, and 80%) of LBPPS. The time interval at each level of the LBPPS treadmill test was 20 minutes to recover to baseline status. We measured systolic blood pressure, diastolic blood pressure, peak heart rate (PHR), rating of perceived exertion (RPE), metabolic equivalents (METs), and oxygen consumption rate (VO₂) during each LBPPS condition. RESULTS: Systolic blood pressure increased as the LBPPS level was increased (40% to 80%). PHR, RPE, METs, and VO₂ were negatively associated with the LBPPS condition, although they were not always significant different among the LBPPS levels. The equation from a random effect linear regression model was as follows: VO₂ (mL/kg/min)=(2.75×stage)+(–0.14×LBPPS level)+11.9 (r²=0.69). CONCLUSION: Detection of the changes in physiological parameters during a submaximal ETT using the LBPPS system may be helpful for applying the LBPPS treadmill in patients who cannot perform the ETT due to gait problems, even at submaximal intensity.
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Humanos , Presión Sanguínea , Prueba de Esfuerzo , Tolerancia al Ejercicio , Marcha , Voluntarios Sanos , Frecuencia Cardíaca , Modelos Lineales , Equivalente Metabólico , Consumo de Oxígeno , RehabilitaciónRESUMEN
OBJECTIVE: To evaluate the effects of cardiac rehabilitation (CR) on functional capacity in obese and non-obese patients who have suffered acute myocardial infarction (AMI). METHODS: Overall, 359 patients who have suffered AMI, and were referred for CR after percutaneous coronary intervention from 2010 to 2015 and underwent an exercise tolerance test before and after phase II CR were included in this study. The patients were divided into two groups: obese group with body mass index (BMI) ≥25 kg/m² (n=170; age, 54.32±9.98 years; BMI, 27.52±2.92 kg/m²) and non-obese group with BMI <25 kg/m² (n=189; age, 59.12±11.50 years; BMI 22.86±2.01 kg/m²). The demographic characteristics and cardiopulmonary exercise capacity of all patients were analyzed before and after CR. RESULTS: There were significant changes in resting heart rate (HR(rest)) before and after CR between the obese and non-obese groups (before CR, p=0.028; after CR, p=0.046), but other cardiopulmonary exercise capacity before and after CR was not different between the groups. HR(rest) (p<0.001), maximal metabolic equivalents (METs, p<0.001), total exercise duration (TED, p<0.001), and maximal oxygen consumption (VO(2max), p<0.001) improved significantly in the obese and non-obese groups after CR. No difference in the change in the cardiopulmonary exercise capacity rate was detected between the groups. CONCLUSION: CR may improve functional capacity in patients who suffered AMI regardless of their obesity.
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Humanos , Índice de Masa Corporal , Prueba de Esfuerzo , Tolerancia al Ejercicio , Frecuencia Cardíaca , Equivalente Metabólico , Infarto del Miocardio , Obesidad , Consumo de Oxígeno , Intervención Coronaria Percutánea , RehabilitaciónRESUMEN
Spontaneous cervical epidural hematoma (SCEH) is an uncommon cause of acute nontraumatic myelopathy. SCEH presenting as Brown-Sequard syndrome is extremely rare. A 65-year-old man had motor weakness in the left extremities right after his mother's funeral. He received thrombolytic therapy under the impression of acute cerebral infarction at a local hospital. However, motor weakness of the left extremities became aggravated without mental change. After being transferred to our hospital, he showed motor weakness in the left extremities with diminished pain sensation in the right extremities. Diagnosis of SCEH was made by cervical magnetic resonance imaging. He underwent left C3 to C5 hemilaminectomy with hematoma removal. It is important for physicians to be aware that SCEH can be considered as one of the differential diagnoses of hemiplegia, since early diagnosis and management can influence the neurological outcome. We think that increased venous pressure owing to repetitive Korean traditional deep bows may be the cause of SCEH in this case.
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Síndrome de Brown-Séquard , Infarto Cerebral , Diagnóstico Diferencial , Diagnóstico Precoz , Extremidades , Hematoma , Hemiplejía , Imagen por Resonancia Magnética , Sensación , Enfermedades de la Médula Espinal , Terapia Trombolítica , Presión VenosaRESUMEN
OBJECTIVE: To investigate the effect of combined therapy of exercise and nootropic agent on cognitive function in a focal cerebral infarction rat model. METHOD: Forty 10-week old male Sprague-Dawley rats were subjected to photothrombotic cerebral infarction of the left parietal lobe. All rats were randomly divided into 4 groups: group A was photothrombotic cerebral infarction rats without any treatment (n=10); group B was photothrombotic cerebral infarction rats with swimming exercise (n=10); group C was photothrombotic cerebral infarction rats with oral administration of acetyl-L-carnitine (n=10); group D was photothrombotic cerebral infarction rats with swimming exercise and oral administration of acetyl-L-carnitine (n=10). Cognitive function was evaluated using the Morris water maze test on the 1st day, and the 1st, 2nd, and 4th week after the induction of cerebral infarction. The activity of superoxide dismutase (SOD) and the level of malondialdehyde (MDA) in the hippocampus were measured. The neuronal cells of the hippocampus were histopathologically evaluated. RESULTS: The escape latency was shorter in groups B, C, and D than in group A. However, the differences were not statistically significant at the 1st, 2nd and 4th week. The activity of SOD was the highest in group D. The level of MDA was the lowest in group D. We observed more normal neuronal cells in groups B, C, and D. CONCLUSION: The combined therapy of exercise and nootropic agent was helpful in ameliorating oxidative stress in the focal cerebral infarction rat model. However, the effect did not translate into improvement of cognitive function.
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Animales , Humanos , Masculino , Ratas , Acetilcarnitina , Administración Oral , Infarto Cerebral , Cognición , Hipocampo , Malondialdehído , Aprendizaje por Laberinto , Neuronas , Nootrópicos , Estrés Oxidativo , Lóbulo Parietal , Piracetam , Ratas Sprague-Dawley , Superóxido Dismutasa , Natación , Naciones UnidasRESUMEN
A 49-year-old man received prolotherapy in the upper cervical region at a local medical clinic. Immediately after the procedure, he felt a sensation resembling an electric shock in his right upper and lower extremities, and continuously complained of numbness and discomfort in the right hemibody. He visited our clinic a week later. Upon physical examination, there were no significant abnormal findings. The visual analog scale was 60 points. T2-weight magnetic resonance images of the cervical spine showed a 0.7 cm sized bright oval spot on the right side of the spinal cord at the level of C4-C5 disc, suggesting spinal cord injury. There were no definite electrodiagnostic abnormalities. Digital infrared thermal images showed moderately decreased surface temperature on lateral aspect of the right forearm and dorsum of the right hand compared with the other side. Considering that very rare complications like spinal cord injury may develop after prolotherapy, we suggest that special interventions such as prolotherapy be performed by professional experts.
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Humanos , Persona de Mediana Edad , Antebrazo , Mano , Hipoestesia , Extremidad Inferior , Espectroscopía de Resonancia Magnética , Mala Praxis , Examen Físico , Sensación , Choque , Médula Espinal , Traumatismos de la Médula Espinal , Columna VertebralRESUMEN
OBJECTIVE: To investigate the effect of regular exercise program on cognitive function in chronic cerebral hypoperfused rat. METHOD: Forty-eight male Sprague-Dawley rats were used. Chronic cerebral hypoperfusion was induced by bilateral common carotid arteries occlusion (BCCAO). All rats were randomly divided into 4 groups: normal rats (group A); normal rats with regular exercise program (group B); BCCAO rats (group C); BCCAO rats with regular exercise program (group D). Regular exercise program was composed of daily 30-minute treadmill exercise for 4 weeks. Cognitive function was evaluated by Morris water maze (MWM) test. The activities of superoxide dismutase (SOD) and the level of malondialdehyde (MDA) were checked. The neurons were microscopically analyzed on Hematoxylin-Eosin and Cresyl violet stains. RESULTS: After regular exercise program, there was significant difference in the escape latency among 4 groups in hidden platform trial of MWM test (p<0.05). There was significant difference in the number of crossings among 4 groups in probe trial of MWM test (p<0.05). The activities of SOD of group A and group D were significantly higher than those of group C, respectively (p<0.05). Histopathological study displayed the formation of apoptotic cell bodies and pyknotic cells in group C and group D. There were more normal neurons in group D than group C. CONCLUSION: Regular treadmill exercise was helpful in improving cognitive function in chronic cerebral hypoperfused rat. Therefore, regular exercise program would be one of the useful strategies for treating chronic neurodegenerative diseases.
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Animales , Humanos , Masculino , Ratas , Benzoxazinas , Arteria Carótida Común , Cognición , Demencia , Malondialdehído , Aprendizaje por Laberinto , Enfermedades Neurodegenerativas , Neuronas , Ratas Sprague-Dawley , Superóxido Dismutasa , Naciones Unidas , ViolaRESUMEN
BACKGROUND: Age is one of the many factors that can influence functional improvement and activities of daily living (ADL) after a stroke. We looked at the effects of functional improvement of hemiplegic upper extremity (HUE) on ADL according to age in stroke patients. METHODS: We recruited 46 stroke patients beginning acute or subacute rehabilitation. They were classified into two groups according to age, the elderly group (> or =65 years, n=18) and the young group (0.05). There were no significant differences in the changes to Pedretti clinical test, MFT, and FIM between the two groups before and after rehabilitation (p>0.05). In the young group, the motor improvement of HUE correlated significantly with FIM (p0.05). CONCLUSION: In our study, elderly stroke patients showed improvement in function and ADL similar to young stroke patients. This potential should be maximized and elderly stroke patients should receive active rehabilitation.