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JKM > Volume 39(3); 2018 > Article
Kim: A case report of a patient with spinal cord infarction treated by Korean medicine combined with conventional medicine: An evaluation using Korean Standard Classification of Functioning, Disability and Health (KCF)

Abstract

Objectives

Korean Standard Classification of Functioning, Disability and Health (KCF), a useful tool for a comprehensive consideration of the health-related overall implications, might be also promising way to validate the effectiveness of Korean medicine. This study reports the change of pre- and post-hospitalization using the KCF in a patient with spinal cord infarction who underwent rehabilitation plus Korean medicine treatment. This study aims to apply the KCF to this case, evaluate its applicability, and review its expected benefits and obstacles in the clinical practice of Korean medicine.

Methods

The changes in the overall health status of the patient were assessed by the KCF as well as the chief complaints, diagnosis, neurological deficits, and activities of daily living (ADL), impairment scale etc. before and after admission to a Korean medicine hospital were investigated.

Results

Most of the chief complaints of the patient were improved enough to perform her daily routine activities independently. These improvements were reflected in the neurological function and ADL scores, but could not change the diagnosis according to the Korean Standard Classification of Diseases nor the impairment scale. The KCF, on the other hand, was able to grasp the changes of the patient in various aspects in terms of body function, body structure, activity and participation, and environmental factors.

Conclusions

Through this case, we found the applicability of the KCF in clinical practice of Korean medicine and the possibility that the KCF can be a promising tool to show the effectiveness and benefits of Korean medicine.

Fig. 1
Change of the Muscle Power Grade
jkm-39-3-89f1.gif
Fig. 2
Change of the Sensory Grade
jkm-39-3-89f2.gif
Fig. 3
Activities of Daily Living Measured by Modified Barthel Index
jkm-39-3-89f3.gif
Fig. 4
Body Functions and Body Structures Measured by ICF Core Set
jkm-39-3-89f4.gif
Fig. 5
Activities & Participation and Environmental Factors Measured by ICF Core Set
jkm-39-3-89f5.gif
Table 1
Motor Function Rating Scale of the International Standards for Neurological Classification of Spinal Cord Injury
Score Motor function
0 total paralysis
1 palpable or visible contraction
2 active movement, gravity eliminated
3 active movement, against gravity
4 active movement, against some resistance
5 active movement, against full resistance
5+ normal corrected for pain/disuse
NT not testable
Table 2
Change of the Routine Laboratory Tests
Category At admission At discharge Unit RV
Chemistry BUN 27.1 15.6 mg/dl 8–20
CRE 0.8 0.7 mg/dl 0.5–0.9
AST 23 25 U/L 8–38
ALT 17 18 U/L 4–44
Hematology WBC 8.5 4.9 103/μl 3.5–10
RBC 3.72 3.49 106/μl 3.5–5.5
Hb 11.1 10.2 g/dl 11.5–15
Hct 32.9 30.8 % 35–55
Platelet 354 286 103/μl 83–100
UA Blood neg neg
Bilirubin neg neg
UB norm norm
Ketone neg neg
Protein neg neg
Nitrite pos pos
Glucose neg neg
pH 8.0 8.0 5–9
S.G 1.015 1.015 1–1.03
Leukocyte 10 10
UM WBC 40–50 40–50 /HPF 0–3
RBC 3–5 3–5 /HPF 0–3
Remarks Bacteria are seen Bacteria are seen

RV: reference value, BUN: blood urea nitrogen, CRE: creatinine, AST: aspartate transaminase, ALT: alanine transferase, WBC: white blood cell, RBC: red blood cell, Hb: hemoglobin, Hct: hematocrite, UA: routine urine analysis, neg: negative, norm: normal, pos: positive, UB: urobilinogen, S.G: specific gravity, UM: urine microscopy, HPF: high power field

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