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To investigate the changing patterns of edema, quality of life (QOL), and patient-satisfaction after complex decongestive therapy (CDT) in three trajectories: arm lymphedema (AL), secondary leg lymphedema (LL) and primary leg lymphedema (PL).
Candidates for AL (n=35), LL (n=35) and PL (n=14) were identified from prospective databases. The patients were treated with CDT for 2 weeks, and lymphedema volume was measured before and immediately following the therapy. Patients then self-administered home therapy for 3 months and presented for a follow-up visit. The Korean version of Short Form-36 (SF-36) was used to assess QOL, and we administered a study-specific satisfaction survey.
There was no significant difference in the volume reductions between the 3 groups. There were no significant differences in all of the measures between PL and LL. Overall initial QOL was significantly lower in patients with LL than in patients with AL. SF-36 scores post-CDT did not differ significantly between AL and LL. Clinically significant differences were noted between AL and LL in the mean values of the satisfaction survey.
AL, LL, and PL may have different longitudinal courses. We suggest that lower extremity lymphedema patients present more favorable outcomes after CDT with respect to QOL and satisfaction than upper extremity lymphedema patients. Clinicians should approach patients with different therapeutic considerations specific to each type or region of lymphedema before using CDT in clinical practice.
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Objective: The purposes of this study were to investigate the factors influencing life satisfaction and quality of life (QOL) of the disabled persons and to help the planning and evaluation of Community Based Rehabilitation (CBR).
Method: Data were collected through personal interviews of 503 registrated disabled persons in Uiwang City. Demographic variables and scores of modified Barthel index (MBI), modified Lambeth disability screening questionnaire (MLDSQ), Craig handicap assessment and reporting technique (CHART) and life domain satisfaction measure (LDSM) were obtained.
Results: The score of LDSM was 4.0⁑1.0. Life satisfaction was related to the age, sex, employment status, severity of disability, educational level, housing and residence, level of instrumental activities of daily living and social integration. MLDSQ score was the most strong predictor of life satisfaction (p=0.00) followed by social integration (p=0.001) and total CHART scores (p=0.017). And the factors influencing the handicap were monthly income, severity of disability, employment, level of education and age.
Conclusion: Based on our study, we suggest that the CBR program of Uiwang City need to focus on improving functional ability and social skill of disabled individual and housing, and also promoting their vocational and educational status. (J Korean Acad Rehab Med 2002; 26: 615-625)
Objective: The purpose of this study was to analyze relationships between injury-related variables, demographic variables, disability, handicap and life satisfaction of persons with spinal cord injury.
Method: Data was collected through personal interviews of 96 persons with spinal cord injury. Neurologic variables, demographic variables, FIM (functional independence measure) scores and CHART (Craig Handicap Assessment and Reporting Technique) scores were obtained. Life domain satisfaction measure, a self-administered questionnare containing 12 items, was used to assess the life satisfaction.
Results: Life satisfaction was related with the total CHART score (p=0.00), severity of disability (p=0.02), annual family income (p=0.019) and employment status (p=0.008). Life satisfaction was not related with the level of injury, age, duration of injury, sex or marital status (p＞0.05). Social integration was the most strong predictor of life satisfaction (p=0.00). Economic-self sufficiency (p=0.004) and FIM scores (p=0.018) were also predictors of the life satisfaction.
Conclusion: The result of this study provides an evidence that social integration and employment warrant a priority in rehabilitation efforts to promote the quality of life following spinal cord injury.
The purpose of this study was to see whether there were any correlations between the clinical findings and outcomes after the epidural steroid injection(ESI), and to determine which of the clinical findings might be of importance as favorable signs to predict a good result with the ESI.
The present study involves 23 elderly patients(18 females and 5 males) with spinal stenosis. The participants were divided into several subgroups according to the clinical features, such as presenting symptoms, age, duration of symptoms and physical findings. Subjects received the epidural injection of 80 mg Depo-Medrol with 6 ml of 1.5% lidocaine solution. The subjects completed a questionnaire before the ESI, and at three weeks and two months after the ESI respectively. The questionnaire included three scales on symptom severity, physical function, and satisfaction. The visual analogue pain scale was utilized as well.
At three weeks, satisfaction outcomes were encountered in 82.6 percent of the sudjects. Differences in the satisfaction between the subgroups according to the duration of symptoms and abnormal physical findings were statistically significant(P＜0.05). The total scores of symptom severity and physical function had improved from the baseline values(P＜0.0001). However, the score changes in each subgroup, for the duration of symptoms differ statistically same (P＜0.05) as assessed by the visual analogue pain scale. The results at two months were similar to those of at three weeks. Approximately 78.3% of the patients reported the satisfactory results. Although the follow up period was short, the results demonstrated that the epidural steroid injection afforded much improvement in clinical symptom and physical function in elderly patients with the lumbar spinal stenosis. The only significant difference was the satisfaction outcomes in the groups with short duration of symptoms. The determination of persisting outcomes from the ESI would require a long-term follow-up study.
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