Vertigo, dizziness, and disequilibrium are common symptoms following concussion or traumatic brain injury. Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage. Some of these patients exhibit features compatible with vestibular migraine and may be treated successfully with migraine preventative medications. This paper reviews the neurological causes of persisting dizziness, the possible mechanisms, and the pathophysiology, as a framework for patient management and for future research.
Anxiety ; Brain Injuries ; Central Nervous System ; Depression ; Diffuse Axonal Injury ; Dizziness ; Ear, Inner ; Humans ; Migraine Disorders ; Motion Sickness ; Stress Disorders, Post-Traumatic ; Vertigo

PURPOSE: This study tries to examine the effects of hand moxibustion and press pellet by applying them to male manufacturing workers with low back pain, and use them to develop nursing interventions for workers. METHODS: The data were collected from August to October, 2018, and the subjects were 60 men, processed by using SPSS/WIN 21.0 to perform homogeneity test with χ²-, t-, and hypothesis tests with repeated measures, ANOVA and Scheffé test. RESULTS: Hypothesis 1 that “the experimental group provided with hand moxibustion and hand press pellet would give lower scores for low back pain than the control group” was supported (F=78.71, p<.001). Hypothesis 2 that “the experimental group provided with hand moxibustion and hand press pellet would have a wider range of motion than the control group” was also supported (F=17.44, p<.001). Hypothesis 3 that “the experimental group provided with hand moxibustion and hand press pellet would give lower scores for depression than the control group,” again, was supported (F=16.95, p<.001). CONCLUSION: Hand moxibustion and hand press pellet are effective in relieving low back pain for male workers, in increasing the range of motion, and in decreasing depression.
Depression ; Hand ; Humans ; Joints ; Low Back Pain ; Male ; Moxibustion ; Nursing ; Range of Motion, Articular

Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.
Arm ; Breast Neoplasms ; Breast* ; Cellulitis ; Depression ; Elbow ; Humans ; Lymphedema* ; Pain Clinics ; Quality of Life ; Range of Motion, Articular ; Risk Factors ; Shoulder ; Stellate Ganglion*

PURPOSE: The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients. METHODS: The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The movie-based nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction. RESULTS: After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001. CONCLUSION: The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.
Depression* ; Humans ; Motion Pictures as Topic ; Motivation* ; Nursing* ; Patient Education as Topic ; Program Development ; Rehabilitation* ; Research Subjects ; Stroke*

PURPOSE: This study is to grasp factors influencing the quality of life in older adults after total knee replacement. METHODS: This study was conducted with 165 older adults who had TKR at four orthopedic hospitals in D city. Data were analyzed using one-way ANOVA, independent t-test, Pearson's correlation, and stepwise multiple linear regression with SPSS 19.0 software. RESULTS: Pain and depression were negatively correlated with range of motion, social support, while sense of coherence was positively correlated with quality of life. Sense of coherence (43%, β=.40), pain (8%, β=−.30), and depression (3%, β=−.20) on the Physical Component Summary in the quality of life have significant explanatory power of 54%. Sense of coherence (49%, β=.44), social support (6%, β=.25), and depression (3%, β=−.22) on the Mental Component Summary in the quality of life have significant explanatory power of 58%. CONCLUSION: This study suggests developing a program to improve the quality of life in older adults who had TKR, considering factors such as sense of coherence.
Adult* ; Arthroplasty, Replacement, Knee* ; Depression* ; Hand Strength ; Humans ; Linear Models ; Orthopedics ; Quality of Life* ; Range of Motion, Articular* ; Sense of Coherence*

PURPOSE: To acknowledge the importance of precise reduction of articular surface of tibial plateau fractures and to make a guideline of treatment by evaluating outcomes and effectiveness of using locking plate and minimally invasive percutaneous osteosynthesis technique. MATERIALS AND METHODS: Twenty-nine patients who underwent surgery for tibial plateau fracture from November 2005 to March 2010 were enrolled with 12 months follow-up in a retrograde manner. The Shatzker classification was used to classify fractures, and we used lateral submeniscal approach to make a precise reduction of articular surface. Radiologic evaluation was determined by presence of bone union, malalignment, and reduction loss or joint depression of articular surface. Post-operative infection, time of active movement of the knee joint, time of partial weight loading, and range of motion (ROM) of knee joint were evaluated. Lysholm Knee Score was used for functional evaluation. RESULTS: Bone union took place in all but one case that developed osteomyelitis. Angulation deformity of more than 10degrees and reduction loss or joint depression of more than 5 mm were not observed. There was one case of osteomyelitis and one case of superficial surgical site infection. There were satisfactory clinical results, with an average time of active knee joint movement and weight loading of 6 weeks. The average ROM of knee joint was 125degrees in the last follow up. As for functional evaluation using Lysholm Knee Score, cases showed an average Lysholm Knee Score of 94 which was a satisfactory result. CONCLUSION: In cases of tibial plateau fractures, if a surgeon accurately reduces the articular surface of joint and use minimally invasive locking plate it will help in bone union biologically, reducing the incidence of soft tissue injuries, and biomechanically maintaining the articular surface of the joint, proving itself to be a useful method of treatment.
Congenital Abnormalities ; Depression ; Follow-Up Studies ; Humans ; Hypogonadism ; Incidence ; Joints ; Knee ; Knee Joint ; Mitochondrial Diseases ; Ophthalmoplegia ; Osteomyelitis ; Range of Motion, Articular ; Soft Tissue Injuries

Vestibular migraine (VM) is an increasingly recognized cause of episodic recurrent vertigo. However, the pathophysiology of VM is still a matter of speculation. An understanding of the relationship between migraine and the vestibular system increases knowledge of the pathogenesis of both migraine and vertigo. The pathophysiology of VM has been known to be related to cortical spreading depression, neurotransmitters (i.e., serotonin, noradrenaline, dopamine, calcitonin gene-related peptide) and calcium ion channel disorder. Moreover, VM is related with Meniere's disease, benign paroxysmal positional vertigo, motion sickness, cerebellar dysfunction, or comorbid psychotic disorder. This review refines recently proposed pathophysiological concept for VM and relationships between migraine and other related disorders.
Calcitonin ; Calcium Channels ; Cerebellar Diseases ; Cortical Spreading Depression ; Dopamine ; Meniere Disease ; Migraine Disorders ; Motion Sickness ; Neurotransmitter Agents ; Norepinephrine ; Psychotic Disorders ; Serotonin ; Vertigo ; Vestibular Neuronitis

OBJECTIVES: To determine which factors are changed in the thyroid cancer postoperative care and how quality of life compared between patients who had undergone modified radical neck dissection and selective neck dissection. METHODS: Prospectively, total 151 patients who diagnosed as thyroid cancer and underwent 16 modified radical neck dissection (mRND) or 135 selective neck dissection (SND) were evaluated for shoulder function, neck mobility, and quality of life and degree of depression at baseline, 2 days and 1 week postoperatively. All patients performed neck and shoulder stretching exercise three times a day beginning the morning following surgery. Shoulder function was assessed with the Constant's shoulder scale. Quality of life was assessed with the SF36v2 questionnaire. And depression was assessed with Beck depression inventory (BDI). RESULTS: The disability scores of patients were significantly worse for neck range of motion (ROM), shoulder pain, ADL, shoulder ROM, shoulder abduction power, total score of Constant's shoulder scale, physical function domain in SF-36v2 and BDI score & grade 2 days after the surgeries. SF36v2 domain score was no significantly difference between two groups. CONCLUSION: The mRND and SND are risk factors for neck ROM limitation, shoulder dysfunction, and onset of depression. In comparison between mRND and SND, more deterioration in ADL, shoulder abduction power, total score of Constant's shoulder scale are associated with modified radical neck dissection. More study is needed about usefulness of the stretching exercise in shoulder pain onset through comparison with control group.
Activities of Daily Living ; Depression ; Humans ; Neck ; Neck Dissection ; Postoperative Care ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Range of Motion, Articular ; Risk Factors ; Shoulder ; Shoulder Pain ; Thyroid Gland ; Thyroid Neoplasms

PURPOSE: The purpose of this study was to analyze the effects of a case management program on range of motion, pain, depression and self efficacy in community-dwelling older women with knee arthritis. METHODS: The research design was one-group pre and post-test design with 40 participants with knee arthritis who agreed to participate in the 12-week case management program. Data were collected four times, before and after 4, 8 and 12 weeks. RESULTS: Repeated measures ANOVA revealed significant differences between before and after the service in range of motion, pain, depression and self efficacy. Significant improvements from the baseline to 4 weeks after the service were observed in the measurements of range of motion, pain, depression and self efficacy. There were no significant differences in range of motion, pain and depression between 4 and 12 weeks after the services. CONCLUSION: This study represents the first effort showing that a case management program can have positive outcomes on range of motion, pain, depression and self efficacy for older women with knee arthritis. More research using a control group pre-post test design considering time lapse is needed in order to examine more accurately the effects of case management programs for knee arthritis.
Arthritis* ; Case Management* ; Depression ; Evaluation Studies as Topic ; Female ; Health Services* ; House Calls* ; Humans ; Knee ; Range of Motion, Articular ; Research Design ; Self Efficacy

PURPOSE: To assess the behaviour of fresh frozen cancellous allograft used for supporting the reconstructed articular surface in impacted tibial plateau fractures. MATERIALS AND METHODS: Between May 2004 and May 2008, 13 cases of impacted tibial plateau fracture were evaluated retrospectively. All fractures were treated with open reduction-internal fixation after restoration of the tibial plateau surface and insertion of fresh frozen cancellous allograft chips for subchondral support. Mean age was 46.6 (31~65) years. Average follow-up period was 36 (13~58) months. The radiological and clinical result for every patient was assessed according to the modified Rasmussen's system and Lysholm's knee score. RESULTS: According to last follow-up weight bearing A-P X-ray, the fresh frozen cancellous allograft incorporated soundly in all cases and no complications such as joint depression, fracture reduction loss, angular deformity, and malunion were found. The mean time to complete bone union was postoperative 10+/-0.7 weeks. The mean range of motion was 135 (115~145) degrees. The mean Rasmussen's radiological score at last follow up was 15.3 (10 cases: excellent, 3 cases: good). The mean Lysholm's knee score at last follow up was 88.2+/-4.3. CONCLUSION: We concluded that fresh frozen cancellous allograft in impacted tibial plateau fractures showed good results in terms of bone union and functional improvement and was considered to be a good structural supporter.
Congenital Abnormalities ; Depression ; Follow-Up Studies ; Humans ; Joints ; Knee ; Range of Motion, Articular ; Retrospective Studies ; Transplantation, Homologous ; Transplants ; Weight-Bearing