• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

• Journal of Acupuncture Research
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• v.30 no.2
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• pp.81-90
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• 2013

Objectives : The purpose on this study is to report clinical effects of oriental medicine for gait disturbance after traffic accident. Methods : The patient was treated using electro-acupuncture, 8 constitution acupuncture, herbal medicine, moxibustion and physical treatment. The effects for gait disturbance have measured with modified barthel index(MBI) and that for lower back pain have measured with visual analog scale(VAS). Results : 1. The Modified barthel index gradually increased according to treatment time. 2. The VAS of low back pain decreased to less than half. Conclusion : Oriental medical treatment showed positive effect on gait disturbance after traffic accident.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.806-814
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• 2016

Objective: To describe the effect of Korean medicine on gait disturbance in a patient with multiple system atrophy and cerebellar ataxia. Methods: We observed a 75-year-old female patient who had multiple system atrophy and cerebellar ataxia. The patient was treated with Korean medicine, including acupuncture, moxibustion, and herbal medicine (Yukmijihwang-tang-gamibang and Boyanghwano-tang-gamibang) for 38 days. We evaluated the patient with the Korean version of the Berg Balance Scale (K-BBS), the Unified Multiple System Atrophy Rating Scale (UMSARS), and the Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient’s symptoms were improved. The K-BBS score increased from 9 to 19, while the UMSARS score decreased from 16 to 12 in Part I, from 15 to 7 in part Ⅱ, and from 4 to 3 in part Ⅳ. The NRS-11 score of gait disturbance decreased from 10 to 5. Conclusions: Korean medicine may be an effective treatment for gait disturbance in multiple system atrophy with cerebellar ataxia.

• The Journal of the Society of Stroke on Korean Medicine
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• v.17 no.1
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• pp.45-54
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• 2016

A case of a 75-year-old Korean female with gait disturbance due to Normal pressure hydrocephalus (NPH) is presented. She was treated with acupuncture, electroacupuncture and herbal medicine - 柴苓湯(Shirhyung-Tang, Chai-ling-tang, Sairei-to) We used iNPH grading scale, and specified further the grade of gait disturbance category. After Korean medical treatment, there was notable improvement in gait disturbance on our specified scale. Cognitive impairment, tremor and rigidity were improved on each scale alongside. Korean medical treatment may be effective in treating NPH patients.

• Journal of Haehwa Medicine
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• v.29 no.2
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• pp.1-11
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• 2020

Objectives : The aim of this study was to report the effectiveness of Combined Korean Medicine treatment on a intracerebral hemorrhage patient with hemiplegia and gait disturbance. Methods : A 56-year-old, female patient with hemiplegia and gait disturbance was treated by Korean Medicine including acupuncture, moxibustion and herbal medicine. The effect of the treatment was evaluated by Manual Muscle Test(MMT), Modified Rankin Scale(MRS), Korean version of Modified Barthel Index(K-MBI). The gait of the patient was evaluated by 10m walk test, Timed Up&Go Test(TUG), Functional Ambulatory Category(FAC), GAITRite and Symmetry Criterion(SC). Results : After treatment, MMT, MRS, K-MBI, gait parameters and gait symmetry were improved. Conclusions : This study suggests that Combined Korean Medicine treatment might be effective for a intracerebral hemorrhage patient with hemiplegia and gait disturbance.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.763-769
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• 2016

Objective: To confirm the immediate gait improvement in a post-stroke gait disturbance patient equipped with a weighted vest. Methods: We selected a patient who was able to walk without another’s help or with tools. The selected patient had an unstable gait because she had only started an independent gait within the past week, so we thought that a weighted vest could be very helpful for her. We first collected gait parameters using a treadmill gait analysis system while the patient walked on the treadmill without the weighted vest. After a 10-minute break, gait parameters were collected again while the patient walked on the treadmill while wearing the weighted vest. The gait parameters we collected included step length (cm), stance phase (%), swing phase (%), SW/ST, and gait line length (mm). For objective evaluation of gait improvement, we calculated the ratio of gait parameters of the right and left limbs. Results: The gait of the post-stroke patient was more symmetrical when wearing the weighted vest than without the weighted vest. Without the weighted vest, her step length ratio was 0.78, stance phase ratio was 0.88, swing phase ratio was 1.50, SW/ST ratio was 1.70, and gait line length ratio was 0.91. With the weighted vest, her step length ratio was 0.88, stance phase ratio was 0.90, swing phase ratio was 1.38, SW/ST ratio was 1.54, and gait line length ratio was 0.98. No side effects were observed due to the weighted vest.

• Journal of Sasang Constitutional Medicine
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• v.17 no.2
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• pp.115-120
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• 2005

l. Objectives To analyse gait disturbance of patient who was operated Total Hip Replacement Arthroplasty(THRA). 'This study is reported to emphasize on psychological stability and balance of vital dynamics. 2. Methods This patient was treated by the remedy of Soyangin, who was diagnosed as Soyangin. We used visual analogue scale(V AS) for the assessment of Rt. femoral pain. 3. Results The patients operated THRA are needed not only rehabilitation of gait, but also psychological stability and balance of vital dynamics. 4. Conclusions We suggest that patients operated THRA are needed not only rehabilitation of gait, but also psychological stability and balance of vital dynamics.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.811-820
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• 2020

Objective: The aim of this study was to report the effectiveness of traditional Korean medicine treatment of a gait disturbance in a patient with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism. Methods: The patient was treated with Korean herbal medicine (Yukmijihwang-tang-gami), acupuncture, moxibustion, and rehabilitation exercise. The gait of the patient was evaluated by the 10 m Walk Test, Timed Up and Go (TUG) test, 360° turning test, Functional Ambulatory Category (FAC), and GAITRite. Results: After 20 days of traditional Korean medicine treatment, we observed improvement in the symptoms of the gait disturbance. Conclusion: Traditional Korean medicine treatment might be effective in the treatment of gait disturbance in patients with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism.

• The Journal of the Society of Stroke on Korean Medicine
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• v.22 no.1
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• pp.31-44
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• 2021

The purpose of this case report is to describe the effectiveness of Korean medicine in the treatment of gait disturbance in advanced stage multiple system atrophy-cerebellar type (MSA-C). This inpatient was treated with herbal medicine, acupuncture, pharmaco-acupuncture, moxibustion, cupping, and chuna therapy. The gait disturbance was assessed by Unified Multiple System Atrophy Rating Scale(UMSARS), Tinnetti test, and 16m walking spatial features. After treatment, UMSARS Part I score was enhanced, decreasing from 29 to 24, Part II score from 34 to 18. Tinetti test score increased from 7 to 20. Gait stride length increased and width decreased. This study suggests that Korean medical treatment could be an effective treatment for delaying the progress of gait disturbance in advanced-stage MSA-C patients.

• The Journal of Internal Korean Medicine
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• v.25 no.2
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• pp.314-319
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• 2004

Objective : This study was designed to evaluate the effects of oriental medicine therapy on a normal pressure hydrocephalus patient. Methods : The clinical data was analyzed on a patient with normal pressure hydrocephalus whose main symptoms were dementia, gait disturbance and urinary incontinence. The patient was admitted to the internal medicine department of Dong-shin University Oriental Hospital from December 7, 2002, and remaind until January 20, 2003. He was treated with herbal medicine(Yukmijiwhangtang), acupuncture and moxa therapy. Results : After treatment, improvement was seen in dementia, gait disturbance, and urinary incontinence. Conclusions : The study suggests that oriental medicine therapy is significantly effective on the treatment or normal pressure hydrocephalus.