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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)

Article information

J Korean Med. 2018;39(3):89-100
Publication date (electronic) : 2018 September 30
doi : https://doi.org/10.13048/jkm.18028
Mikyung Kimorcid_icon
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 2018 September 3; Revised 2018 September 14; Accepted 2018 September 14.

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

Motor Function Rating Scale of the International Standards for Neurological Classification of Spinal Cord Injury

Change of the Routine Laboratory Tests

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Article information Continued

Copyright © 2018 The Society of Korean Medicine all rights reserved

Fig. 1

Fig. 1

Change of the Muscle Power Grade

Fig. 2

Fig. 2

Change of the Sensory Grade

Fig. 3

Fig. 3

Activities of Daily Living Measured by Modified Barthel Index

Fig. 4

Fig. 4

Body Functions and Body Structures Measured by ICF Core Set

Fig. 5

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