• 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 Korean Physical Therapy
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• v.16 no.4
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

• Journal of Biomedical Engineering Research
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• v.35 no.3
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• pp.55-61
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• 2014

In sleep monitoring system, polysomnography (PSG) is the gold-standard but previous studies revealed that attaching numerous amount of sensors disturb sleep during the test which is the fundamental disadvantage of PSG. We suggest an unconstrained rapid-eye-movement (REM) sleep monitoring method measured with polyvinylidene (PVDF) film-based sensor for the normal and the obstructive sleep apnea (OSA) patients. Nine normal subjects and seventeen OSA patients have participated in the study. During REM sleep, rate and variability of respiration are known to be greater than in other sleep stages. Based on this phenomena, respiratory signals of participants were unconstrainedly measured using the PVDF-based sensor with the PSG and REM sleep were extracted from the average rate and variability of respiration. In epoch-by-epoch REM sleep detection, proposed method classified REM sleep with an average sensitivity of 72.3%, specificity of 92.5%, accuracy of 88.9%, and kappa statistic of 0.60 compared to the results of PSG. Student's t-test showed no significant difference between the results of normal and OSA group. This method is potentially applicable to REM sleep detection in homing environment or ambulatory monitoring.

• Journal of the Ergonomics Society of Korea
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• v.35 no.6
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• pp.493-501
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• 2016

Objective: This study analyzes the effect of angle conditions of rehabilitation equipment used for supporting hemiplegic patients on their rehabilitation training for standing action. The study was performed by adjusting the rear angle of seat inclination through a motion analysis. Background: Owing to a loss of muscle rigidity and degradation of muscle control ability, hemiplegic stroke patients suffer from asymmetrical posture, abnormal body balance, and degraded balance abilities due to poor weight-shifting capacity. The ability to shift and maintain one's weight is extremely essential for mobility, which plays an important role in our daily life. Thus, to improve patients' ability to maintain weight evenly and move normally, they need to undergo orthostatic and ambulatory training. Method: Using a motion analysis system, knee movements on both hemiplegic side and non-hemiplegic side were measured and analyzed in five angles ($0^{\circ}$, $10^{\circ}$, $30^{\circ}$, $50^{\circ}$, $70^{\circ}$) while supported by the sit-to-stand rehabilitation equipment. Results: The knee movements on both sides increased as the angle increased in angle support interval to support a hemiplegic patient's standing up position. In standing up interval, a hemiplegic patient's knee movement deviations on both sides decreased, and the movement differences between hemiplegic and non-hemiplegic legs also decreased as the angle increased. Conclusion: The results of this study showed that the rehabilitation effectiveness increases as the angle increases, leading to a balanced standing posture through the decrease of movement difference between hemiplegic and non-hemiplegic sides and an improved standing up ability through the increase of knee movement on both sides. However, angles higher than $50^{\circ}$ didn't provide a significant effect. Therefore, a support angle under $50^{\circ}$ was proposed in this study. Application: The results of this study are expected to be applicable to the design of sit-to-stand support equipment to improve the effectiveness of the rehabilitation process of hemiplegic patients.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.1
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• pp.15-22
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• 2012

Purpose : We investigated the effects of the combined use of FES and over ground walking with partial body-weight support (PBWS) on walking function and balance control in people with chronic strokes. Methods : Twenty-seven people who were ambulatory after chronic strokes were evaluated. The exercise's intervention consisted of the combined use of FES and over ground walking with PBWS and general exercise groups. The FES + PBWS group and general exercise group consisted on a-20-minute session per day, 3 times a week during a 4 week period. The evaluation was carried out before, after, and two weeks after the exercise intervention. Outcome measures were a 6 Minute Walk Test, 6-Meter walk Test, Timed Up and Go Test, and a Balance Test, measured before and after the exercise interventions at a-2 week follow up. Results : The endurance was significantly increased in both the FES+PBWS group and general exercise group (p<0.05). Significant increase on the gait velocity was observed in both the FES+PBWS group and general exercise group (p<0.05). The TUG was significantly different in both the FES + PBWS group and general exercise group (p<0.05). However there were no differences in both the between-group & interaction. The stability index was significantly different in both the FES + PBWS group and general exercise group (p<0.05). Conclusion : In conclusion, the combined use of FES and over ground walking with PBWS led to an improvement in walking function and balance control. Thus, it is possible to combine the use of FES and over ground walking with PBWS for physical therapy intervention to improve walking function and balance control. It is suggested to apply this intervention in the clinical field.

• Physical Therapy Korea
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• v.24 no.2
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• pp.58-65
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• 2017

Background: Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP. Objects: This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP. Methods: Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement. Results: The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved. Conclusion: SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.1
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• pp.17-26
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• 2015

Purpose : This study examined the social and environmental change in the outpatient department of psychiatry, were analyzed disease characteristics and using characteristics of the mental illness. Thus, this aims to provide a material that can be used for efficient spatial composition of psychiatry. Methods : This study was conducted through a literature review, observation surveys, interviews. Results : Psychiatry is aware of the need to respond to the current needs of ambulatory space, there are concerns that the spatial configuration for your needs. In accordance with the results of studies conducted are as follows: 1) Specialty care programs and space needs based on segmentation and specialization of the disease 2) Considered in conjunction with the layout of essential space and other departments 3) Spatial composition and furnishings for characteristic of psychiatry 4) Spatial configuration taking into account the patient's characteristic. Implications : This study looked at the change of social change and the environment related to psychiatry. Grasp the present state of spatial composition in psychiatry. And the use characteristics of patients and guardians were investigated. Meanwhile, studies of psychiatric outpatient department is still lacking. As a result, its significance is to analyze the spatial composition requirements.

• Journal of Oral Medicine and Pain
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• v.41 no.1
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• pp.7-15
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• 2016

Purpose: Mandibular advancement device (MAD) is widely recognized as an important treatment option for obstructive sleep apnea (OSA) and is readily accepted than any other treatment options owing to its simplicity and ambulatory nature. At this time, there are a multitude of MAD designs and their efficacies may be influenced by adjustment and retention mechanism. The MAD with the anterior connector (anteriorly adjustable mandibular advancement device, AAMAD) was newly developed in the Department of Oral Medicine, Dankook University Dental Hospital (Cheonan, Korea) and was prescribed for the OSA patients including snoring patients. Thus, this study was aimed to objectively investigate the effectiveness of the AAMAD on the OSA patients using the self-applied portable device (ApneaLink), and evaluate the treatment outcomes among patients with various severity of OSA level. Methods: Results of the treatment of fourteen patients (13 male, 1 female) with the AAMAD were retrospectively analyzed. Each patient underwent home sleep test before treatment and were divided into two groups, i.e., those with mild (apnea-hypopnea index [AHI] ${\geq}5$ and <15) to moderate OSA (AHI ${\geq}15$ and <30) and severe OSA (AHI ${\geq}30$). After treatment, home sleep test was conducted again and treatment outcomes were compared between mild to moderate and severe OSA patients. Results: Of all patients, 78.6% showed more than 50% AHI reduction. We found a significant reduction (85.3%) of AHI in the severe OSA patients. Patients with mild to moderate OSA showed the reduced AHI (56.1%). Conclusions: We concluded that AAMAD is an effective oral appliance for the majority of OSA patients.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.55-60
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• 2001

Objectives : The SERVQUAL scale is based on gap theory, which suggests the difference between consumers' expectations and the quality of the medical service actually received. However, problems in the implementation of the SERVQUAL scale have been identified by several researchers. Some researchers have proposed a simple performance-based measure (SERVPERF) or au exportation-controlled performance-based measure(Non-Diff) as alternatives to the SERVQUAL scale. On the basis of the theoretical concerns discussed, we examined the capability of each of the three scales(SERVQUAL, Non-Diff, SERVPERF) to explain variations in consumer satisfaction. Methods : Data was gathered from a self-administered questionnaire in a 430 bed hospital. Questionnaires evaluating medical services were distributed to 180 ambulatory patients. A total of 167 usable questionnaires were gathered. The questionnaire was composed of 10 expectation, performance and expectation-controlled performance items. In addition, overall satisfaction and purchase intention were measured. Results : Compared with the SERVQUAL scale, the Non-Diff and SERVPERF scales better explained the observed variations in consumer satisfaction(SERVOQUAL, $R^2=0.29;\;Non-Diff,\;R^2=0.51;\;SERVPERF,\;R^2=0.48$) and purchase intention(SERVQUAL, $R^2=0.22;\;Non-Diff,\;R^2=0.33;\;SERVPERF,\;R^2=0.34$). Conclusion : The maier conclusion from our study is that the Non-Diff and SERVPERF scales are more efficient in assessing consumer satisfaction than the SERVQUAL scale. Therefore we suggest that consumer satisfaction he measured by the Non-Diff or SEVPERF scales.

• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.2
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• pp.125-132
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• 2011

Background: Adult patients with intellectual disabilities often strongly resist the anesthetic administration for dental procedures. This study aimed to evaluate the effect of midazolam premedication in improving the cooperation level of patients who are likely to be combative and irritated during general anesthesia (GA) induction. Methods: The patients who had received dental treatment under ambulatory GA for more than two times were included. And we selected 13 patients total that needed physical restraint or ketamine IM prior to induction at the first GA, and were prescribed midazolam tablet (7.5-15 mg) at the following GA. We reviewed pre-anesthetic records and anesthesia records, and evaluated cooperative levels of patients (4 levels scale) during anesthesia induction and recovery time retrospectively. Results: All 13 patients (Male 11, Female 2) had severe mental disabilities. The average age of the patients was 24 ${\pm}$ 7 (13-37) years and their average weight was 58 ${\pm}$ 16 (34-91) kg. At the first GA, 10 patients needed physical restraint prior to induction (level 3). And 3 patients were so poorly cooperative that the induction procedure was performed after intramuscular injection of ketamine (level 4). But after the midazolam intake, 7 patients were willing to receive the anesthetic induction (level 1, 2), and 6 patient needed physical restraint (P < 0.05). There were no statistical differences in the duration of general anesthesia and postoperative recovery. Conclusions: Oral intake of midazolam was effective in improvement of cooperation without any complications.