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)

Mikyung Kim; Kim, Mikyung

doi:10.13048/jkm.18028

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)

Case Report

The Journal of Korean Medicine 2018; 39(3): 89-100.

Published online: September 30, 2018

DOI: https://doi.org/10.13048/jkm.18028

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)

Mikyung Kim^*

Department of Internal Medicine, College of Korean Medicine, Sangji University

Correspondence to：김미경 강원도 원주시 우산동 283 상지대학교 부속한방병원 TEL: +82-33-741-9215, E-mail: 01mkkim@gmail.com

Received September 3, 2018 Revised September 14, 2018 Accepted September 14, 2018

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.

Keywords: KCF, ICF, spinal cord injuries, Korean medicine

Fig. 1

Change of the Muscle Power Grade

Fig. 2

Change of the Sensory Grade

Fig. 3

Activities of Daily Living Measured by Modified Barthel Index

Fig. 4

Body Functions and Body Structures Measured by ICF Core Set

Fig. 5

Activities & Participation and Environmental Factors Measured by ICF Core Set

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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