• 생물정신의학
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• 제27권2호
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• pp.42-57
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• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• 대한물리치료과학회지
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• 제25권2호
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• pp.15-23
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• 2018

Purpose: The purpose of this study was to investigate the effects of Interferential current stimulation therapy(ICT) on pain, balance, and walking ability of elderly patients with chronic low back pain. Methods: Twenty participants were randomly assigned to ICT group (2 males and 8 females) and placebo ICT group (3 males and 7 females). Participants were ICT and placebo ICT for 20 minutes, and the pre- and post-VAS, TUG and postural balance were measured. Results: The ICT group showed significantly decreased pain scores in the elderly patients with chronic low back pain (p<.05) than the placebo ICT group. The postural fluctuation with eyes opened and closed was significantly lower than the placebo ICT group(p<.05), and the ICT group showed remarkable improvement (p<.05). Conclusion: ICT was expected to improve decrease pain, improve postureal sway and walking ability remarkably. Therefore, It was expected that the application or ICT would be an effective method for elderly patients with Chronic Low Back Pain.

• 가정간호학회지
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• 제25권1호
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• pp.96-104
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• 2018

Purpose: This study compared factors related to fear of falling among women in the early phase of old age based on hand grip strength. Methods: Researchers obtained data of 1,071 women who had participated in the 4th Korean Longitudinal Study of Aging. Data were analyzed using multiple regression analysis. Results: In both groups, fear of falling was positively correlated with falling experience within two years, osteoarthritis-related leg pain, depression, and instrumental daily life abilities; however, self-rated health was negatively correlated. In the low hand grip strength group, self-rated health, osteoarthritis-related leg pain, and hand grip strength accounted for 21.3% of the variance regarding fear of falling. In the normal hand grip strength group, age, self-rated health, fall experience within two years, osteoarthritis-related leg pain, and depression significantly accounted for 16.6% of the variance regarding fear of falling. Conclusion: In applying interventions to prevent falling in women in the early phase of old age, health care workers must verify if women have low hand grip strength and determine whether to focus on fitness improvement through exercise interventions or consider psychological interventions for depression.

• 한국전문물리치료학회지
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• 제9권2호
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• pp.51-59
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• 2002

The purpose of this study was to determine the effect of intramuscular stimulation (IMS) therapy in older persons with musculoskeletal pain. The subjects were 181 older persons (54 males, 127 females) with musculoskeletal pain. Intramuscular stimulation unit with needles (size $.3{\times}30$ mm) was applied for the treatment. The analgesic effects were measured by visual analog scale (VAS). Results showed that the post-treatment VAS score was significantly decreased after IMS therapy for fifteen minutes compared to pre-treatment score. In addition, the post-treatment VAS score was significantly decreased in patients with chronic pain (pain duration of one year after onset) compared to the post-treatment VAS score in patients with subacute pain (pain duration less than three months after onset). There was no significant difference in analgesic effects according to gender and age groups. It is determined from this study that IMS therapy can be beneficial for patients with chronic musculoskeletal pain in clinical setting. Further study is needed to identify whether the IMS therapy can change the pain threshold in patients with neurologic pain.

• 대한물리치료과학회지
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• 제16권4호
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• pp.29-37
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• 2009

Background: The purpose of this study was influence of change of electrical stimulation time on body regions affects on electrical current threshold. Methods: The present study is to examine the effect of silver spike point (SSP) electrical stimulation (1Hz), transcutaneous electrical nerve stimulation (TENS, 100Hz), and interferential current therapy (ICT, 50Hz) from the low back and scapulodorsal and knee joint regions on stimulation-induced current thresholds from the elderly (over sixty) people (male:72, female:91) in senior welfare center. Result: The low back region, but not scapulodorsal and knee joint region, significantly increased the TENS and ICT, but not SSP, electrical stimulation, significantly increased the time-dependent current thresholds in elderly patients. Conclusion: Therefore, these results, in part, suggest that the TENS and ICT were shown to be a more adaptable method of stimulation, and that needed of the development of senile specialized physical therapy and the utilization of senior leisure facilities such as senior welfare center the others.

• 대한통합의학회지
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• 제6권4호
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• pp.183-189
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• 2018

Purpose : As age increases, a low-level systemic inflammatory state develops and the levels of anti-aging hormones decrease. The vagus nerve activates parasympathetic nerves and promotes sulfation and secretion of neurotransmitter in the brain. Therefore, the purpose of this study was to investigate the effects of electrical vagus nerve stimulation on systemic inflammation (CRP) and anti-aging hormone (DHEA-S) levels in elder people. Methods : A total of 30 healthy elder people participated in this study, randomly divided into two groups of 15 subjects. Electrical vagus nerve stimulation was applied to the experimental group for 4 weeks. CRP and DHEA-S levels were compared with those of the control group. Results : The CRP level was significantly lower in the experimental group than in the control group. In the experimental group, there was a significant decrease in CRP before and after the intervention. However, the DHEA-S level was not significantly different between groups. Conclusion : Electrical vagus nerve stimulation may alleviate the low-level systemic inflammatory state found in elderly people. These results suggest that it may have the effect of reducing the degenerative inflammatory diseases of the elderly and delaying aging.

• 대한물리치료과학회지
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• 제13권2호
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• pp.67-83
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• 2006

The present study examined that in Vivo/Vitro test is investigated in normotensive sham-operated rats (NSR) and aldosterone-analogue deoxycorticosterone acetate (DOCA)-salt hypertensive rats (ADHR) and that the antihypertensive effect was induced by silver spike point (SSP) electrical stimulation at meridian points(CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52), specifically, such as aldosterone in 24 hour urine analysis from healthy volunteer. The gross examination and morphometric-histological changes, such as hypertrophy, production of necrotic tissues, and the changes of cell arrangement on the kidney, and adrenal gland were markedly observed in aldosterone-analogue DOCA-salt hypertensive rats compared with those from normotensive sham-operated rats. The systolic blood pressure, weight of kidney and adrenal gland were significantly increased in ADHR than that in NSR. The required time of PSS-induced resting tone was significantly increased in ADHR than that in NSR. However, the voltage-dependent K+ (Kv) currents were significantly decreased in ADHR than that in NSR. The urine analysis showed that the concentration of aldosterone was significantly decreased in resting state from the elderly people compared with those from the adolescent healthy volunteer. The current of 1 Hz continue type of SSP electrical stimulation significantly decreased in the concentration of aldosterone of 24 hour urine from the elderly people. These results suggest that the development of aldosterone analogue-induced hypertension is associated with changed the weight of kidney and adrenal gland, blood pressure, resting tone and Kv currents, which directly affects blood pressure. Therefore, the hypertension is a risk factor on cerebrovascular disease. Moreover, these results suggest that the diminished responsiveness to SSP electrical stimulation, especially current of 1Hz continue type, in elderly people may be, in part, related by the increased of antihypertensive effects.

• 한국산학기술학회논문지
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• 제20권10호
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• pp.415-424
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• 2019

최근 고령인구의 증가로 인해 실내 외에서 고령자들이 편리하게 생활할 수 있는 다양한 재활복지기기에 대한 관심이 증가하고 있다. 본 논문에서는 거동이 불편한 노인 또는 장애인들 스스로가 좁은 실내에서 안전하고 편리하게 이동과 이승이 가능하도록 최소 회전반경과 문턱 극복을 포함하여 설계 제작하였다. 좌식문화가 발전한 실내 환경에서 골절질환, 노인질환 및 기타 무릎, 허리질환을 가진 사용자의 이승 편의성을 제공하고자 하였다. 먼저 실내에서 이 승강이 가능하도록 프레임에 기본적으로 링크, 시트, 암레스트, 커버, 모터, 감속기, 배터리, 충전기, 센서, 컨트롤러 기구물 등을 부착하였다. 사용자의 환경과 신체적 특징을 고려하여 제품 디자인과 구조물을 설계하였으며, 고령자 또는 장애인이 실내에서 일상생활을 지원할 수 있도록 IoT 기능을 추가하였다. 제작된 실내 이 승강 휠체어의 동작성능을 확인하기 위해 구동실험을 수행하였다. 연속 주행시간, 회전반경, 액추에이터 최대부하, 최대 승강 높이, 음압레벨, 운행 보조센서 센싱 최소거리, 서버 및 앱 프로그램 상호 연동과 기기호환성, 듀티 사이클 오차율 시험성능 테스트를 수행하였다. 시험결과, 제작된 휠체어는 각 항목의 성능시험 목표 값을 달성하였으며, 성공적으로 작동하는 것으로 나타났다.

• 치위생과학회지
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• 제17권4호
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• pp.323-332
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• 2017

본 연구는 20세 이상 경제활동자의 구강검진 수진에 영향을 미치는 요인을 파악하기 위해 제6기 국민건강영양조사(2014) 자료를 이용하여 복합표본설계로 분석하였다. 구강검진 여부에 응답한 2,843명을 대상으로 다음과 같은 결론을 얻었다. 첫째, 20세 이상 경제활동자의 건강검진 수진율은 66.5%, 구강검진 수진율은 30.1%로 건강검진 수진율 절반 수준에도 미치지 못하였다. 둘째, 소인성 요인에 따른 구강검진 수진 여부를 비교한 결과 연령에서 40대(34.3%)와 50대(34.3%)가 가장 높고, 30대(30.1%), 20대(27.5%), 전기노인(24.9%), 후기노인(12.0%) 순이었다. 셋째, 가능성 요인에서는 개인소득이 상위집단일수록, 교육수준이 높을수록 구강검진 수진율이 높았다. 개인소득이 하위그룹에 비해 상위그룹이 구강검진을 받을 확률이 1.50배 높았고, 대졸 이상인 사람에 비해 초졸 이하인 사람은 0.37배, 중졸인 사람은 0.49배 구강검진을 받을 확률이 낮았다. 건강보험종류에 따라 직장보험(33.5%) 가입자가 지역보험(24.2%) 가입자에 비해, 민간의료보험 가입자(31.7%)가 비가입자(22.7%)에 비해 구강검진 수진율이 높게 나타났다. 넷째, 필요성 요인에서는 치통을 경험한 사람(36.9%)이 치통을 경험하지 않은 사람(25.9%)에 비해, 구강검진 수진 확률이 0.55배 낮았다. 영구치우식 유병자(23.2%)가 영구치우식 비유병자(33.0%)보다 구강검진 수진 확률이 0.62배 낮았다. 이상의 결과로 볼 때 20세 이상 경제활동자의 구강검진 수진에 영향을 미치는 요인은 의료자원의 이용을 가능하게 하는 외적요인인 가능성 요인(개인소득, 교육수준, 건강보험종류, 민간의료보험가입 여부), 상병의 수준을 의미하는 필요성 요인(치통 경험 유무, 영구치우식유병 여부), 질병 이전부터 존재해 온 개인의 특성을 의미하는 소인성 요인(연령) 등이 복합적으로 작용하는 것으로 나타났다. 따라서 효과적인 구강검진 및 치료체계를 확립하기 위해서는 개인의 구강관리라는 행태적 요인뿐만 아니라 의료자원의 이용을 가능하게 하는 가능성, 소인성, 필요성 등 다양한 요인을 종합적으로 고려할 필요가 있음을 본 연구결과는 시사해 주고 있다.

• 보건행정학회지
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• 제9권3호
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• pp.95-112
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• 1999

The objectives of this study were to develop the therapeutic recreation programs for relieving depressive symptoms of the elderly and to verify the effect on their psychological condition. The key elements of these programs, which consisted of 9 sessions. were aerobic exercises, group dynamics. and making fun. These programs were developed through a multidisciplinary approach with social workers and the faculties of preventive medicine. The social workers gave these programs to fifteen elderly people at the community center, so called noinjung, for 9 weeks. Before intervention of this program for the experimental group, the baseline was measured by GDS(geriatric depression scale). After intervention for 9 weeks, GDS as an outcome was measured to evaluate the effects of the program. This data was analyzed by $X^2$-test and Wilcoxon signed rank test. and the results were as follows: 1. Based upon the cutting point(GDS = 5) which could distinguish between depression group and normal group, the number for the normal group increased, while the number for the depression group decreased slightly after intervention with the therapeutic recreation programs, however, there was no significant change(p〉0.05). 2. The score of GDS decreased significantly after intervention with the therapeutic recreation programs(p〈0.05). 3. The scores of GDS decreased in widow(or) group and in female group compared to those of the married group and the male group, respectively(p〈0. 05). 4. The score of GDS increased in groups with similar labor and emotional support compared to those of groups with sufficient or less support, respectively(p〈0.05), These findings indicate that the therapeutic recreation programs might be effective for relieving depressive symptoms of the elderly. It is, therefore, suggested that this program be modified and standardized through review of the intervening process, experimental results, and responses of clients for appling in other noinjungs.