Purpose : This study was aimed at investgating the effect of McKenzie exercise on temporomandibular joint disorder (TMJD) and body balance. Methods : Thirty subjects with TMJD were selected. They were randomly assigned to one of two groups (15 in each group) : namely the conservative treatment group and McKenzie exercise group. The conservative treatment group were treated physical therapy for 6 weeks (3 times a week). The McKenzie exercise group performed McKenzie exercise for 6 weeks (3 times a week). We measured mouth opening, pain, muscle activation and body balance before and after exercise by using the maximum mouth opening MMO), visual analog scale (VAS), electromyography and Biodex Balance System, respectively. Results : We found statistically significant differences in pain and mouth opening in the conservative treatment group and McKenzie exercise group before and after (p<.05). Conclusion : We confirmed the effect of McKenzie exercise on TMJD. Thus we thought these results could be used as basic data and reference for TMJD. But we need more study effect of McKenzie exercise on TMJD and body balance.

Purpose : The purpose of this study was to investigate the effect of abdominal muscle strengthening exercise on abdominal muscle strength and respiratory function in stroke patients. Methods : The subjects were 14 stroke patients (10 males, 4 females) hospitalized at W rehabilitation hospital in Busan City and randomly assigned to 7 exercise groups and 7 control groups. Exercise was performed in combination with an upper and lower extremity pattern of proprioceptive neuromuscular facilitation. Measurements of abdominal muscle strength and respiratory function were made before intervention and 4 weeks after intervention. Abdominal muscle strength was assessed using a digital manual dynamometer, and respiratory function was assessed by spirometry. The collected data were analyzed with a paired t-test and independent t-test and the significance level was set as α =.05. Results : The results showed that applying abdominal muscle strengthening exercise to stroke patients showed a significant increase in abdominal muscle strength and a significant difference between groups (p<.05). Maximal-effort expiratory spirogram (MES) readings were significantly increased in forced vital capacity (FVC), and forced expiratory volume in one second (FEV₁), in the exercise group, and there were a significant differences between the groups in terms of FEV1 (p<.05). Slow vital capacity (SVC) was significantly increased in vital capacity (VC), tidal volume (TV), inspiratory reserve volume (IRV), and expiratory capacity (EC), and there were significant differences between the groups in VC, TV, expiratory reserve volume (ERV), EC, and inspiratory capacity (IC) (p<.05). Conclusion : Abdominal muscle strengthening exercise was effective in the abdominal muscle strength of stroke patients, and it was confirmed to have a positive effect on the enhancement of respiratory function. Therefore, it seems that exercise programs for stroke patients with respiratory weakness should include abdominal muscle strengthening exercises.

Purpose : The purpose of this study was to evaluate the effects of multi-sensory treatment programs on attention and learning in ADHD children. Methods : The program was provided for 50 minutes twice a week for a total of 12 times over 6 weeks. The FAIR concentration test was used to identify the children's concentration of attention before and after the intervention. The children's learning ability was evaluated using K-ABC. Results : When attention was evaluated using FAIR, there was a significant increase in all dependencies of performance value (P), quality value (Q), and continuity value (C) (p>.05). In addition, when learning ability was evaluated using K-ABC, learning ability in general increased significantly (p>.05). The multi-sensory play therapy program had a positive effect on the children's attention and learning ability and thus it is a positive intervention method for children with ADHD. Conclusion : In addition to providing challenging activities, the program showed that it was possible to elicit the children's interest by engaging a variety of senses at the same time. This is believed to have motivated them internally to engage actively in the program.

Purpose : The muscle strength of iliopsoas (IL) was measured commonly in sitting position with hip and knee flexed 90°. However, there is no study to determine the muscle strength of IL in various test positions. Therefore, the purpose of this study was to compare the muscle strength of IL and muscle activity of rectus femoris (RF) according to test position and knee flexion angle. Methods : Twenty healthy subjects were participated for this study. The muscle strength of IL and muscle activity of RF were measured by hand-held dynamometer and surface electromyography during maximum voluntary isometric contraction (MVIC) of IL, respectively. The muscle strength of IL and muscle activity of RF was measured in 4 conditions as follows; 1) knee flexion angles 90 ° in supine, 2) 130 ° in supine position, 3) 90 ° in sitting, 4) 130 ° in sitting. Each condition were performed randomly by three repetitions. Results : The muscle strength of the IL was the main effect on the test position and knee flexion angle (p<.05), and the muscle activity of RF was the main effect only on the knee flexion angle (p<.05). There was also no interaction between the factors (p>.05). In supine position, the muscle strength of IL in knee flexion 130 ° was significantly less than that in knee flexion 90 ° (p<.0125). In knee flexion 90 °, the muscle strength of IL in supine position was significantly greater than that in sitting position (p<.0125). The muscle activity of RF in knee flexion 130 ° was significantly less than that in knee flexion 90 ° in supine and sitting positions (p<.0125). Conclusion : When the muscle strength of IL was measured in clinic and sports fields, the supine position with knee flexion 130 ° was recommended to prevent the muscle activation of RF and to maintain the trunk stability.

Purpose: This study aimed to analyze the affecting factors related to cancer screening for persons with disabilities. Methods: We examined the factors affecting cancer screening in individual aged older than 20 years who participated in the 2017 National Survey of the Disabled. The subjects were 6031 individuals with disabilities who were aged older than 20 years. Data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression with the SPSS Win 21.0 software. Results: Cancer screening among persons with disabilities is differentiated based on age, education level, marital status, type of disability, grade of disability, subjective house economic status, health insurance, chronic disease, unmet healthcare needs, suicidal thinking, and health screening. The significant predictors of health screening were age, marital status, chronic disease, and health screening. Conclusion: Based on the results of this study, it is necessary to develop a program for young, medical care recipients to improve the participations of disabled in cancer screening.

Purpose : The purpose of this study was to determine the influence of the elastic-band exercise program for elderly who over 65 years old in terms of depression and physical self efficacy. We aim to suggest interventions with an elastic-band exercise program for elderly. Methods : The study subjects selected were females or males 65 years old or more who could walk without assistance and could talk about daily living without mental or physical disorders. A total of eight subjects understood the purpose of this study and agreed to participate. Before and after the exercise program, the subjects were monitored for changes in their physical self-efficacy and depression. To measure the physical self-efficacy, we used a perceived physical ability scale and physical self-presentation confidence scale (Cronbach α =0.942). To measure depression, we used the geriatric depression scale short form (Korea version, Cronbach α =0.969). The data obtained from each measure were analyzed using the Wilcoxon signed rank test to determine changes from before and after the exercise program. The program consisted of three parts (warm-up, main exercise and cool-down) and included the upper extremities, the lower extremities and trunk exercises with an elastic band (yellow and red). The program lasted for 15 weeks, once a week, with each session lasting for 60 minutes. Results : After 15 weeks of the elastic-band exercise program, there was a significant decrease on the depression scale (p<0.05) and significant improvements on the physical self-efficacy scale (p<0.05). Conclusion : Based upon our results, we demonstrated that the exercise program using the elastic band was effective in improving the depression and physical self-efficacy of the elderly.

Purpose : Human gingival fibroblast cell is one of the the main cell types in periodontal tissue, which they can show anti-inflammatory activity through the production of numerous lines of inflammatory mediators such as inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2 and interleukins. Porphyromonas gingivalis, one of the oral pathogens, has reported to play a critical role in the development of periodontal diseases. This study aimed to investigate anti-inflammatory and antioxidative activities of Gracilaria textorii ethanol extract (GTEE) in P. gingivalis derived lipopolysaccharide (LPS-PG) stimulated human gingival fibroblast (HGF)-1 cell line. Methods : In order to analyze anti-inflammatory and antioxidative activities of GTEE in HGF-1 cell line, NOS enzyme activity, expression levels of iNOS, COX-2, NAD(P)H quinone dehydrogenase (NQO)1 and their transcription factors were estimated by Griess reaction and western hybridization. Results : LPS-PG induced overexpression of iNOS and COX-2, which was significantly attenuated by GTEE treatment in a dose-dependent manner without any cytotoxicity. In addition, intracellular NOS activity was in accordance with the result of iNOS expression. Due to important role in the regulation of inflammatory responses, phosphorylated status of p65 and c-jun, each subunit of nuclear factor (NF)-κB and activator protein (AP)-1, was also dose-dependently ameliorated by GTEE treatment. One of phase II enzymes, NQO1, and its transcription factor, nuclear factor erythroid 2-related factor 2 (Nrf2), were analyzed since elevated phase II enzyme expression inhibited inflammatory response, which was significantly elevated by GTEE treatment in HGF-1 cell line. Conclusion : In conclusion, GTEE mitigated LPS-PG-stimulated inflammatory responses by attenuating NF-κB and AP-1 activation as well as accelerating NQO1 and Nrf2 expression in HGF-1 cell line. These results indicate that GTEE might be utilized a promising strategy for potential anti-inflammatory agent in periodontal diseases.

Purpose : Several studies suggest that smoking and vitamin D level is a risk factor of metabolic syndrome. The objective of this study is to evaluate the association between smoking status, vitamin D levels and the Korean adult male and female metabolic syndrome. Methods : We assessed 3796 participants aged 19 years and older from the Korean National Health and Nutritional Examination Survey 2013, 2014. Smoking statuses were collected from self-reported questionnaires. Subjects were divided into three categories: non-smokers, former smokers, and current smokers. Vitamin D was tested by Radioimmunoassay method and the value of serum 25-hydroxyvitamin D, which is an index of vitamin D status in the body, was used. The diagnosis of metabolic syndrome was made using criteria modified NCEP-ATP III. Logistic regression analysis was used to calculate odds ratios between smoking status, vitamin D levels, and metabolic syndrome. Results : The overall prevalence of metabolic syndrome was 23.0 % in men and 15.4 % in women. After adjusting for smoking, the odds ratio for men's metabolic syndrome in current smokers was 1.77 (95 % CI, 1.30~2.41), while for former smokers OR was 1.63 (95 % CI, 1.15~2.31) compared with nonsmokers. After adjustment vitamin D, the odds ratio for women's metabolic syndrome in vitamin D deficiency was 1.44 (95 % CI, 1.11~1.87) compared with normal. Conclusion : Smoking status was associated with an increased risk of metabolic syndrome in Korean adult males and decreased vitamin D level was associated with an increased risk of metabolic syndrome in Korean adult females.

Purpose : The purpose of this paper is to review the continuing education (CE) for physiotherapists and especially to draw attention to the perception and need of the education so that the present study aimed to provide information for improving the education program. Methods : The study obtained information from CE of the Korea Physical Therapy Association held in Gwangju on April 12 and July 19, 2015 to understand the perception and needs of CE. Present study showed that 431 out of 563 people who answered to the survey, with a 76.5 % response rate. Among them, 350 people were selected for the final analysis, except for questionnaires whose responses were insufficient. Among them, the level of perception of CE was 238, excluding 112 people who did not receive an education in 2014. Results : The perception of CE according to experience showed a weak positive correlation in questions 1 (r=.244), 5 (r=.244) and 10 (r=1.129) (p<.05). There was no significant correlation in questions 2, 3, 4, 6, 7, 8, and 11 (p>.05). The needs of CE according to experience showed weak negative correlations in musculoskeletal system (r=-.141), nervous system (r=-.136), geriatric (r=-.117), oriental physical therapy (r=-.130), and other new technologies (r=-.232) (p<.05). Basic education, pediatric, cardiopulmonary system, sports, physical agents, and women's fields were not significantly correlated (p>.05). Conclusion : There was little or no significant correlation between perception and needs for the CE based on physical therapists' experiences. Current research suggests that for a CE for physical therapists, the perception of education should first be renovated, and then the quality of education should also be improved based on the need of them.

Purpose : The purpose of this study was to investigate the development of korean vowels by acoustically analyzing whether children produce Korean vowels differently according to their age and gender between ages 4 and 6. Methods : A total of 104 children aged 4~6 years (56 males and 48 females) participated in this study. The participants were classified as either 4, 5, or 6 years old. Vowel speech data was obtained by asking the subjects to pronounce meaningful words in which the vowel in question was located in the first syllable. Speech analysis was performed using the Multi-speech 3700 program. Results : Age, gender, and vowel being pronounced all had significant effects on intensity. There was significant decrease with increasing age, and the intensity was significantly higher in male children than female children. Neither age, gender, nor the vowel being produced affected the fundamental frequency. The fundamental frequency produced did not differ by age or gender. The first and second formants had considerable effect on age and vowels, significantly decreased with age, and did not have a gender difference. Conclusion : The results of this study showed that children aged 4~6 have similar anatomical structures, but that maturity of speech motor skills required to pronounce vowels was correlated with age. The results of this study can be used to evaluate children's speech and develop speech therapy programs.

Purpose : Using qualitative research and a phenomenological approach, the present study aimed to explore men's experiences of becoming a nurse. We posed the question "What has been your experience of becoming a nurse?" Methods : Eleven male nurses from three regions in Korea were selected through convenience sampling. The protocol suggested by Colaizzi was used for data analysis. Results : The principal themes were "Challenging to the stochastic stereotype of gender mechanics," "Floating outside the enclosure of multiple groups," "The male nurse's conceptualization of nursing organizations," "To stand with self-doubt, thinking of it as a stopover," and "Situations encountered by a male nurse." Conclusion : Men experience gender discrimination based on the social roles that are imposed on males and females both at school and in the workplace. They prefer to work where they have more diverse tasks that require quick responses. However, most male nurses adapt to this work by outlasting the difficulties. These nurses become accustomed to their tasks, and satisfied with their mature work performance. They often feel they are not adequately compensated for their work. They may judge the future as uncertain, and have lingering doubts about maintaining their positions, ultimately gravitating toward specialized fields that promise a brighter future and are more consistent with traditional gender expectations.

Purpose : The purpose of this study was to investigate the meta-analysis on the effects of action observation training on stroke patients' walking. Methods : Domestic databases (DBpia, KISS, NDSL, and RISS) were searched for studies that conducted randomized controlled trials (RCTs) associated with action observation training in adults after stroke. The search outcomes were items associated with the walking function. The 18 studies that were included in the study were analyzed using R meta-analysis. A random-effect model was used for the analysis of the effect size because of the significant heterogeneity among the studies. Sub-group and meta-regression analysis were also used. Egger's regression test was conducted to analyze the publishing bias. Cumulative meta-analysis and sensitivity analysis were also done to analyze a data error. Results : The mean effect size was 2.77. The sub-group analysis showed a statistical difference in the number of training sessions per week. No statistically significant difference was found in the meta-regression analysis. Publishing bias was found in the data, but the results of the trim-and-fill method showed that such bias did not affect the obtained data. Also, the cumulative meta-analysis and sensitivity analysis showed no data errors. Conclusion : The meta-analysis of the studies that conducted randomized clinical trials revealed that action observation training effectively improved walking of the chronic stroke patients.

Purpose : The purpose of this study was to investigate the interrelationship between eye movement and auditory function through the effects of eye lateralization on transient evoked otoacoustic emissions of auditory function. Methods : 25 subjects with complete set of ears were used in this study, which composed of 12 males and 13 females with pure tone threshold of below 25 dB without otolaryngology were evaluated. Each of the patient has a visual acuity of greater than 1.0 after correction, and has no problems with eye disease, eye movement, and human parallel system. In a dark silent room, the subjects sat on a chair with their heads fixed on a headrest. The tests were performed by asking the patients to look at a fixed red light dot on a light bar in front of them. This light was directed to the front, right and left sides of the subject at an angle of 40 ° In the presence of the stimulus sound in the ipsilateral ear, the transient evoked otoacoustic emissions of the ipsilateral ear was measured at the straight, right and left fixation. In order to evaluate the transient evoked otoacoustic emissions through the efferent auditory pathway, the transient evoked otoacoustic emission values of the contralateral ear were measured at the straight, right and left fixation. These measurements were taken at frequencies of 1 kHz, 1.4 kHz, 2.0 kHz, 2.8 kHz and 4 kHz, respectively. Results : Transient evoked otoacoustic emissions caused by lateral movement of the eye showed significant changes at 1.4 KHz and 2 KHz of the afferent pathway of the ipsilateral ear. Also, significant changes were observed at 1.4 KHz and 4 KHz of the efferent pathway of the contralateral ear. Conclusion : These results indicated that there is a close relationship between eye movement and auditory cochlea. In the future, further studies considering more diverse subjects and age groups will be needed.

Purpose : This study examined the hand function and visual motor integration capabilities in 30 children with developmental disabilities. The children were divided into an experimental group (n=20) that received digital sensory perception training and a control group (n=10) that did not receive this training. Methods : Training was conducted a total of 12 times for six weeks, for 50 minutes a day, twice a week, for the experimental group. The Jebsen-Taylor Hand Function Test was used to determine the hand function before and after the intervention, and the Beery VMI-6 was performed to identify the visual motor integration capability. Results :After the intervention, the ability to perform hand functions and visual motor interaction increased significantly in the experimental group but not in the control group. Digital sensory training therefore had a positive effect on the hand function and visual motor integration in children with developmental disabilities. Conclusion : A digital sensory perception training program is an arbitration method that can positively improve the hand function and visual motor integration ability in children with developmental disabilities.

Purpose : This study aimed to evaluate the effects of sitting questionmark exercise (SQE) and brugger's relief exercise (BRE) on pain, ROM, proprioception, NDI in 60 Patients with Chronic Cervical Pain (CCP). Methods : In this study the VAS and NDI were used to investigate changes in pain and disability with SQE and BRE. The pre and post intervention intra group differences were analysed with a paired t-test for mean values, and the inter group differences were analyzed with an independent t-test for mean values. Results : The pain of both of groups was lowered with statistical significance. Pain of SQE group is lower than that of BRE group with statistical significance. ROM in both groups was improved, but there is no significant difference between two groups. NDI in both of groups were significantly decreased after the intervention, but there was no significant difference between groups. there was NDI ratio (%) significant difference between each groups. Conclusion : SQE intervention may be considered a more effective clinical approach for reducing pain and restoring proprioception in patients with CCP.

Purpose : This study aimed to investigate the effects of a thoracic flexibility exercise program on pain, heart rate variability (HRV), and depression in patients with chronic low back pain. Methods : Fifty patients with chronic low back pain participated in this study. Each participant performed a pre-test and post-test. The outcome measures evaluated were a visual analog scale, HRV test results (automatic activity, standard deviation normal to normal [SDNN], low frequency [LF], high frequency [HF], and LF/HF ratio), and the Beck Depression Inventory. Patients underwent conventional physiotherapy for 35 minutes per session. In addition, a thoracic flexibility exercise program (trunk rotation exercise, McKenzie exercise, and supine thoracic extension exercise) were performed 3 times per week for 4 weeks. Results : After the training period, the visual analog scale results showed a significant decrease in the post-test compared to the pre-test. Automatic activity, SDNN, LF, HF, and LF/HF ratio significantly increased in the post-test compared to the pre-test. The Beck depression inventory results significantly decreased in the post-test compared to the pre-test. Conclusion : This study demonstrated that a thoracic flexibility exercise program improves a visual analog scale, HRV (automatic activity, SDNN, LF, HF, and LF/HF ratio), and the Beck Depression Inventory in patients with chronic low back pain.

Purpose : The purpose of this study is to understand the experiences of nursing students in clinical practice at a public health center through their self- reflections. Subjects : The 110 students in the 3rd year, practice at two public health centers in city P and city K. From the110, 53 male and female university students who practice in city K were selected to participate : 11males (20.8 %) and 42 females (79.2 %). Methods : The data analyzed were the self-reflections regarding the clinical practice. Results : These data indicate that : most of the participants now believe that public health centers provide many more services to the community than they previously knew about. They rate the public health center's programs highly, and want to be community health nurses. For the first time, they realize that the work of public health nurses is very important. In particular they note that their emotions while at the public health center differ significantly from when they work at the other. The environment in the public health center makes them feel more comfortable and less stressed. Generally, they are satisfied with their practice at the public health center. Conclusion : On the basis of these findings, the following recommendations can be made. Experience at public health centers is an important part of nursing students' education. I suggest that research on nursing students' experiences while practicing at the public health center should expand to include research methods other than the analysis of their reflection journals, In addition a follow-up study of experiences while practicing at the public health center should be attempted of self-reflections.

Purpose : This narrative research study aimed to identify the degree of correlation between hospice awareness and knowledge of and attitude toward advance directives. Methods : A survey was conducted from July 5 to July 15, 2018 with 210 adults in C city, Gyeongsangnam-do. Using the SPSS 21.0 program, the data analysis methods utilized were the independent t-test, one-way ANOVA, Scheffe, and Pearson's correlation coefficients. Results : The degree of hospice awareness was measured according to the general characteristics of the subjects, which were as follows: heard about economic level, importance of religion, heard of hospice, heard about advance directives, and intention to execute advance directives. The knowledge of advance directives had significant differences by age, hospitalization experience, religion, and being the final decision maker for a family problem. The attitude toward advance directives differed significantly by marriage status and the intention to write an advance directives. The relationship between hospice awareness and knowledge and attitude toward advance directives showed a positive significant correlation (r=.47, p<001). The relationship between knowledge of and attitude toward advance directives also indicated a positive significant correlation (r=.20, p=.005). Conclusion : This study provided basic data to inform promotion of hospice awareness and an educational intervention about advance directives.

Purpose : The study was conducted to analyze the differences in perceptions, attitudes, and knowledge of health tourism students' medical tourism industry as a basic data for improving the curriculum for human resource development that can be activated by the medical tourism industry. Methods : The questionnaires were directly distributed and retrieved from 394 university students attending 4 year college health department and tourism department of some regions (IRB approval number, KW-2017-05). The questionnaire used the Likert 5-point scale to analyze differences in perceptions, attitudes, and knowledge levels in the medical tourism industry. Independent sample t tests were conducted to examine the differences in perceptions, attitudes, and knowledge about the medical tourism industry between the two groups. Results : Results obtained from this study are as follows. 1. Differences in perceptions of the medical tourism industry were 3.44 points for health and 3.45 points for tourism (p<.05). 2. The difference in attitude level was 2.28 for health and 2.79 for tourism. And that tourism has a high perception and attitude. The knowledge of medical tourism industry was 5.93 in health department and 7.11 in sight tourism, and the tourism sector was significantly higher (p<.001). 3. As a result of analysis on attitudes, interest, direct and indirect experience, practical knowledge acquisition, and development possibility were all statistically significant. 4. 98.6 % of the health students and 97.8 % of the tourism students did not obtain the qualification for the qualification of the international medical tourism coordinator. However, in the future, respondents who answered that they have obtained the certificate of international medical tourism coordinator responded positively to 54.9 % of tourism department and 25.2 % of health department. Conclusion : A systematic education of the medical tourism industry will improve the level of human resource development in the medical tourism industry, including the acquisition of international medical tourism coordinator certification, as well as the level of medical tourism industry awareness, knowledge and attitude.

Purpose : The purpose of this study was to determine the correlation between the self-esteem of health science college students and their empathy for others. Methods : A survey was administered to 448 students from the five departments of health science (Occupational Therapy, Physical Therapy, Dental Hygienics, Nursing, and Medical Administration) at a college located in Busan, South Korea, between September 28 and November 2, 2017. To measure their self-esteem and empathy for others, the Self-esteem Scale and the Korean Empathy Quotient (K-EQ) Scale were used. Results : There were statistically significant differences in social skills as a sub-item of empathy skills based on age and department, as well as in emotion as a sub-item of empathy skills based on sex. Self-esteem and all the items of empathy showed meaningful differences based on monthly expenses, while self-esteem and cognition as a sub-item of empathy skills displayed significant differences based on source of monthly income. Noteworthy differences were also found in self-esteem and emotion as a sub-item of empathy skills based on satisfaction with current school life. Self-esteem and empathy skills were shown to have a positive correlation. Conclusion : According to the results of this study, self-esteem and empathy skills had a statistically significant correlation. Further research is needed to investigate how health science college students can improve their understanding of themselves and their empathy for others.

Purpose : The purpose of this study was to compare stress and psychological status between a stroke and a fracture patient's caregivers. Methods : Data was collected from September to December 2018 and participants of this study were 60 stroke and 61 fracture patient's caregivers. Stress was evaluated with the Global Assessment of Recent Stress scale-Korean Version and psychological status was measured with the Symptom check List-90-Revision. Results : The stroke patient's caregivers scored significantly higher than the fracture patient's caregivers in stress relevant to interpersonal, change in relationship, sickness or injury, financial, change/no change in routine (p<.05). The stroke patient's caregivers scored significantly higher in somatization, interpersonal sensitivity, depression, anxiety, paranoid ideation, and psychoticism than the fracture patient's caregivers (p<.05). Conclusion : It was found that the severity of mental health in the stroke patient's caregivers is necessary to develop a customized mental health improvement program for stroke patient's caregivers.

Purpose : Wellness tourism is defined as travel for the purpose of promoting health and well-being through physical, psychological, or spiritual activities. The development and verification of a comprehensive wellness program for health care for workers is needed. The purpose of this study is to investigate the wellness and skin health effects of skin health programs in order to develop high-value health care services. Methods : The subjects were 15 middle-aged women who understood the research and volunteered and participated in the two-day skin health wellness program. Participants were measured to determine their wellness index and skin health twice: before and after participating in the program. Wellness index measures include comprehensive wellness, physical wellness, mental wellness, emotional wellness, social/cultural wellness, financial wellness, and environmental wellness. Skin health measurement items consisted of skin oil, skin water, skin pore, skin elasticity, skin wrinkle, and skin pigment. The skin wellness program included aerobic exercise, endurance exercise, functional food, cosmetics, herbal tea, massages, spa treatments, meditation, and marine leisure sports. The t-test analysis was used to compare the difference between wellness index and skin health measurement items before and after the program. Results : Among the wellness index items, the comprehensive wellness index (p<.05), mental wellness index (p<.05) and environmental wellness index (p<.05) showed statistically significant differences. Among skin health items, skin oil (p<.05), skin elasticity (p<.01) and skin wrinkle (p<.01) all showed statistically significant differences. There was no statistically significant difference in physical wellness, emotional wellness, social/cultural wellness, financial wellness, skin water, skin pore and skin pigment. Conclusion : This study confirmed that the two-day complex wellness program is an effective program for some items of wellness index and skin health.

Purpose : This study aimed to determine whether resistance exercise using elastic bands for 6 weeks could improve the muscle strength, muscle tone, balance and gait among stroke patients. Methods : A total of 11 stroke patients who had agreed to participate in the study were randomly divided into 3 groups receiving elastic band resistance training on their less affected side (experimental group 1, n=4), affected side (experimental group 2, n=3), and both the sides (experimental group 3, n=4). Muscle strength, muscle tone, balance and gait were assessed using a hand-held dynamometer, the modified ashworth scale (MAS), the berg balance scale (BBS), and G-walk respectively, before and after training. Wilcoxon signed-rank test was used to analyze intergroup changes after the intervention, whereas the Kruskal Wallis H test, and Mann-Whitney U test were used to analyze intergroup changes in all variables. Results : Strength in all the muscle, except for the flexor and extensor muscles in the affected knees, was increased in all the groups, however, no significant difference was observed. No change in the muscle tone (MAS) was found in any group. All the groups showed increased BBS scores walking speed, and walking symmetry following training, although, the differences were not significant. Changes in the affected step length of experimental group 1 were significantly greater than those of experimental group 3, whereas changes in the affected step length in experimental group 3 were significantly greater than those of experimental group 2. Conclusion : Our results suggest that resistance exercise using elastic bands are a potential intervention for improving lower extremity muscle strength, balance, and gait among stoke patients.

Purpose : The purpose of this study was to investigate the depression, self-efficacy, and stress level of middle-aged women and to identify the factors affecting on stress, and to provide base line data for the development of nursing intervention for stress reduction of middle-aged women. Methods : Participants were 200 middle-aged women aged 40 to 60 who live in Seoul and Gyeonggi Province. Data collection period was from March 1, 2019 to April 15. In this study, the questionnaire of life events-stress, depression scale, self-efficacy was used. Data were analyzed by average, standard deviation, minimum, maximum, correlation and regression using the SPSS Program 21.0. Results : The results of this study, the correlation between depression, self-efficacy and stress in middle-aged women, depression and self-efficacy (r=-.264, p<.001), self-efficacy and stress (r=-.279, p<.001) had a significant negative correlation, depression and stress (r=.268, p<.001) had a significant positive correlation. Depression and self-efficacy were the factors affecting the stress of middle-aged women. Depression was β =.207 (p<.001) and self-efficacy β =-.222 (p=.003). Depression had the greatest influence on stress, followed by self-efficacy. Conclusion : Middle-aged women are an important time to prepare for a successful old age. Considering that the current middle-aged women are the subjects of the future aging society, their physical, psychological, and social problems are very important in preventing the elderly problems of the aging society. Therefore, effective nursing interventions should be developed that to reduce the depression and stress in middle-aged women and to improve self-efficacy and improve the quality of life of middle-aged women.

Purpose : The purpose of this study was to identify the self-efficacy, major satisfaction, and degree of adjustment to college life of nursing students and the relationships among the foregoing. Methods : This study was conducted with 319 nursing students in B city from May to June 2019. The collected data were analyzed with frequency, percentage, mean and standard deviation, t-test, ANOVA, Scheffe's test, and Pearson Correlation Coefficient using the SPSS /WIN 22.0 program. Results : The self-efficacy score of nursing college students was shown to be 2.95±0.32 points, major satisfaction score was shown to be 3.83±0.55 points, and college adjustment score was shown to be 3.52±0.55 points. The degrees of adjustment to college life were significantly different according to general characteristics of nursing students as follows; grade (F=6.614, p=.000), health condition (F=13.384, p=.000), club activities (t=4.557, p=.000), happiness index (F=32.094, p=.000), part-time job (t=2.781, p=.006), and motive of major selection (F=7.300, p=.000). The adjustment to college life of nursing students showed a weak negative correlation with self-efficacy (r=-.196, p<.001) and a strong positive correlation with major satisfaction (r=.782, p<.001). Major satisfaction and self-efficacy showed a weak negative correlation (r=-.185, p<.001). Conclusion : Through the results of this study, it can be seen that repetitive studies are necessary in relation to the self-efficacy, major satisfaction, and college adjustment of nursing students, and that interest in effort for the development of programs that can improve nursing students' major satisfaction and college adjustment are necessary.

Purpose : Excessive computer use frequently results in musculoskeletal disorders of the neck and shoulder such as forward head posture (FHP). The purpose of this study was to investigate effects of neck and shoulder exercise program on spino-pelvic alignment and the correlation between change in head and neck posture and spino-pelvic alignment in FHP. Methods : The study included 44 participants with FHP. The participants performed the exercise for correction of FHP 2-3 times a week for 4 weeks. We examined whole spine X-ray images in the lateral standing position with both arms crossed. We measured anterior head translation distance (AHT), craniovertebral angle (CVA), cervical lordosis (CL), thoracic kyphosis (TK), lumbosacral lordosis (LSL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) of the subjects. The association between change in AHT and each spino-pelvic parameter was also subjected to Pearson's correlation coefficient analysis. Results : There were statistically significant differences before and after exercise in the parameters of AHT, CVA, and SS (p<.05). Significant negative correlation was observed between the change in AHT and CVA (r=-.768, p<.001), and CL (r=-.388, p<.05). There was significant positive correlation between the change in AHT and SS (r=.328, p<.05), and PI (r=.333, p<.05). However, no significant correlation was observed in change in AHT with that of TK, LSL, and PT. Conclusion : Based on the above results, we conclude that there is a relationship between change in AHT, which is a parameter associated with forward displacement of the head, and that of CVA, CL, SS, and PI after exercise in cases of FHP.

Purpose : The purpose of this study was to provide the effective method for exercise therapy in soccer player. Methods : 30 soccer players were recruited for subjects. The subjects were divided to dynamic stretching exercise combined tDCS (Group I), dynamic stretching exercise combined Sham-tDCS (Group II) of which 15 subjects were randomly allocated. The subjects were given 3 hour of soccer skill and performance and additionally given 20 minutes of dynamic stretching exercise combined tDCS and sham-tDCS for each group, five times a week, for 6 weeks. Their muscle activity and jump performance were analyzed before the intervention. After 6 weeks of the intervention, the mentioned parameters were measured once more for between-group analysis. Results : Comparative analysis of the muscle activity and jump performance between the groups I and groups II showed statistically significant difference. Conclusion : Such results revealed that dynamic stretching exercise combined with tDCS is effective in muscle activity and jump performance. Based on the current study, more effective program is to be proposed for neurologic and musculoskelectal disorder as well as soccer player. Based on the current study, studies that incorporates various combine of variable is required for development of effective tDCS program.

Purpose : The purpose of this study was to find out how changes in body shape of obese patients could be affected by the combined management of diet and psychotherapy along with exercise therapy to control energy imbalance, the cause of obesity. Methods : In this study, the aerobic exercise program was conducted on 12 industrial workers of "D" company for a total of eight weeks for obese patients with a high body mass index (25 kg/㎡ or higher). The experimental group did not apply the program three times a week. The body type analysis was carried out using the body analyzer (Inbody 770, Inbody, Korea) and blood test and psychological test were performed after 8 weeks of exercise before and after exercise. Results : The results of the group showed a change in weight loss of 6.03 kg (p=.000) on average, which is nearly 10 % of the change in weight. It was also shown that the BMI (body mass index) decreased by 1.76 kg/㎡ (p=.000). Abdominal fat (AO) is also 0.14 % (p=.000), waist circumference (WC, 12.72 cm, p=.000), internal fat (VF, 25.12 %, p=.000), liver function levels AST (5.47 U/L, p=.04), ALT (13.64 U/L, p=.000), total cholesterol, pTC -14.22. Conclusion : Based on the results of this study, the obesity management program will be able to maximize the effects of obesity control if exercise programs and psychotherapy are combined.

Purpose : This study focuses on the influence of bridge exercise combined with whole body vibration on muscle activity and balance. Methods : 30 stroke patients were recruited for subjects. The subjects were divided to bridge exercise combined stable surface (Group I), bridge exercise combined unstable surface (Group II), and bridge exercise combined bridge exercise (Group III), of which 10 subjects were randomly allocated. The subjects were given 30 minutes of neurologic physical therapy which included gait training and muscular strength training, and additionally given 30 minutes of bridge exercise combined stable surface, bridge exercise combined unstable surface, and bridge exercise combined whole body vibration for each group, five times a week, for 8 weeks. Their muscle activity and balance were analyzed before the intervention. After 8 weeks of the intervention, the mentioned parameters were measured once more for between-group analysis. Results : Comparative analysis of the muscle activity and balance between the groups showed statistically significant difference, and post-hoc analysis showed the Group III had greater changes in muscle activity and balance than Group Iand Group II. Conclusion : Such results revealed that bridge exercise combined with whole body vibration is effective in muscle activity and balance. Based on the current study, more effective program is to be proposed for elite athletes as well as stroke patients. Based on the current study, studies that incorporates various frequencies of vibration is required for development of effective whole body vibration exercise program.

Purpose : The purpose of this study was to provide an effective method of exercise therapy for patients with cervicogenic headache. Methods : The subjects were divided into the following two groups according to the intervention received: cervical stretch exercise (n=15, control group) cervix-stabilizing exercise (n=15, experimental group) tone (Hz) and stiffness (N/m) of the suboccipital and upper trapezius muscles were measured. T1 slope angle and neck tilt angle were measured. After the exercise program intervention, a greater amount of change in muscle tone and stiffness of suboccipital and upper trapezius muscles was found in the experimental group, as compared to the control group. Greater amount of change in posture was found in the experimental group, as compared to the control group (p<0.05). Results : After the exercise program intervention, a greater amount of change in muscle tone and stiffness of suboccipital and upper trapezius muscles was found in the experimental group, as compared to the control group. Greater amount of change in posture was found in the experimental group, as compared to the control group (p<0.05). Conclusion : The neck-stabilizing exercise were shown to be effective in decreasing the tone of the cervical muscles by stabilizing the cervical bone and improving muscle activity, and in improving the posture by decreasing muscle tone and stiffness.