PURPOSE: A good, valid, and feasible tool for evaluating sit to stand (STS) is needed to help clinicians quantify the STS ability of stroke patients and people with balance disorders. The purpose of this study was to evaluate the concurrent validity of the Nintendo Wii Balance Board (WBB) and a force plate during STS and gait. METHODS: Seventeen healthy adults performed five trials of STS and gait on the WBB placed on the force plate. The force plate and the WBB were compared in regard to center of pressure (COP) and ground reaction force (GRF) data that were collected simultaneously. The variables used for analysis were time (s), integral summation (%), COP path length (mm), COP x range, and COP y range, all of which were measured for both tasks. Counter (%), peak (%), and rebound (%) were analyzed for STS, and $1^{st}$ peak (%), min peak (%), and 2nd peak (%) were analyzed for gait. The concurrent validity was analyzed using an intraclass correlation coefficient (ICC) and a standard error of measurement (SEM) with a 95% confidence interval. RESULTS: The concurrent validity of the WBB for STS ranged from fair to good (ICC=.701~.994, SEM=.029~3.815). The concurrent validity for gait was good (ICC=.869 ~.989, SEM=.007~2.052) aside from path length and x and y ranges of COP (ICC=-.150~.371, SEM=3.635~4.142). CONCLUSION: The GRF of the WBB has a good validity for STS and gait analysis. The WBB is remarkably portable, easy to use, and convenient for clinically assessing STS and gait.
The purpose of study was to compare plantar pressure during walking wearing the curved rear balance and normal shoes. Twelve university students(height: $177.2{\pm}4.6cm$, weight: $68.4{\pm}5.8kg$, age: $26.2{\pm}1.6yrs.$) who have no known musculoskeletal disorders were recruited as the subjects. Plantar foot pressures were evaluated using the Tekscan's pressure measurement systems while subjects walked upright position wearing the curved rear balance and normal shoes in random order at a speed of 1.3 m/s. The contacting dimension, the mean plantar pressure, and the peak plantar pressure were determined for each trial. For each dependent variable, paired t-test was performed to test if significant difference existed between shoe conditions (p<.05). As a result, the curved rear balanced shoes showed as large as 38 up to 50 % of area at the rear side of feet than the normal shoes when measuring the contact area with upright position. In the distribution of average pressure, the curved rear balanced shoes displayed fairly low pressure compared to other normal shoes in general except for one area, which is M2, and especially, the measured pressures at the both rear (M1) and middle (M5) side of feet were low and statically significant. The contact area of the curved rear balanced shoes when walking was significantly larger at the rear (M1) and fore (M6, M7) side of feet. When considering pressure distribution at walking, low pressure was detected at the rear side of feet with the curved rear balanced shoes and at the fore side of feet for other normal shoes. The results showed that the contacting dimension of the curved rear balance shoes that acts between shoes and feet was higher than the corresponding value for the normal shoes in general; therefore it would reduce the pressure to the feet by allowing the each sole of the foot on the ground evenly.
Purpose: This study aimed to investigate the impact of a nurse shift improvement pilot project on nurses' shift adjustment, work-life balance, and turnover intention, as well as nurses' experiences of participating in the pilot project. Methods: An explanatory sequential mixed-methods study was performed. Survey data was collected from a total of 1,051 nurses both in participant and non-participant groups. For the qualitative study, focus group interviews were conducted with 22 nurses who participated in the shift improvement pilot, including 12 staff nurses, 7 nurse managers, and 3 substitute nurses. Results: There were significant positive effects on the key variables of nurses' shift adjustment, work-life balance, and turnover intention in the group that participated in the nurse shift improvement pilot project. Based on the qualitative study, participants in the shift improvement pilot project indicated that it enabled nurses to recover their circadian rhythm, and achieve a better work-life balance, and they wanted to continue working as a nurse, and hoped expanded application of the pilot project. Conclusion: In order for expanded implementation of the pilot project and continued improvement in the shift system, we recommend establishing compensation standard, systematizing the use of substitute nurses, developing guidelines for shift schedules, and expanding the shift improvement pilot project to other departments such as the emergency room.
Lecca, Luigi I.;Fadda, Paolo;Fancello, Gianfranco;Medda, Andrea;Meloni, Michele
Safety and Health at Work
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제13권2호
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pp.148-154
/
2022
Background: Bus driving is a mentally demanding activity that requires prolonged attention to ensure safety. The aim of the study was to assess mental fatigue caused by driving a public bus and to find a profile of workers at higher risk. Methods: We evaluated changes of critical flicker fusion (CFF) (index of central arousal) and heart rate variability (HRV) (index of autonomic balance) in a 6-hour driving shift on a real route, in 31 professional bus drivers, and we tested the influence of personal factors such as sleep quality, BMI, and age. Paired t-test was used to test differences of CFF and HRV between both initial and final phase of driving, while multiple linear regression tested the influence of personal variables on the indexes of mental fatigue. Results: Results showed that CFF significantly decreased after 6 hours of bus driving (41.91 Hz, sd 3.31 vs. 41.15 Hz, sd 3.15; p = 0.041), and heart rate significantly decreased in the final phase of driving, with respect to the initial phase (85 vs. 78 bpm, p = 0.027). Increasing age (beta = -0.729, p = 0.022), risk of obstructive sleep apnea syndrome (beta = -0.530, p = 0.04), and diurnal sleepiness (beta = -0.406, p = 0.017) showed a significant effect on influencing mental fatigue. Conclusion: Elderly drivers at higher risk of sleep disorders are more prone to mental fatigue, when exposed to driving activity. Monitoring indexes of central arousal and autonomic balance, coupled with the use of structured questionnaires can represent a useful strategy to detect profile of workers at higher risk of mental fatigue in such duty.
Purpose: Physical therapists are required to properly choose the most appropriate treatment for each patient within the framework of the International Classification of Functioning, Disability, and Health (ICF model). The aims of this study were to determine whether neurological physical therapists in clinical settings in South Korea know about the ICF model and to investigate the current trends of outcome measures (OMs) used by them. Methods: Two hundred and one physical therapists who worked with patients with neurological disorders participated in this study. The survey was conducted via e-mail and asked about commonly used OMs and the considerations for selecting OMs. Results: All physical therapists involved in this study responded completely, and 45.8% of participants learned about the ICF model, while 37.3% understood the detailed information related to the ICF model. The rest of the participants did not know or just heard about the ICF model. The most frequently used tools at the body function/structure level were the Range of Motion (98%), Manual Muscle Test (97%), Berg Balance Scale (83.1%), and Modified Ashworth Scale (70.6%) when allowing repetition. At the activity level, the 10-meter walk test (71.1%), 6-minute walk test (54.2%), and Functional Ambulatory Category (43.3%) were used, while the Activity-Specific Balance Confidence Scale (23.9%) was used at the participation level. There was a positive relationship between the number of tools used and years of work, as well as the level of understanding of the ICF model. Conclusion: The results of this study suggest that it is necessary to learn the ICF model in a clinical setting. In addition, the medical system needs to be modified to encourage physical therapists in South Korea to use proper OMs within the ICF model.
Purpose : Along with the rapid development of digital technology, the application of digital healthcare in the medical field is also increasing. According to many experts, increasing the amount of exercise and physical activity is a helpful way to prevent and manage physical problems in modern society. However, a lack of exercise, which is of the lifestyle of modern people, leads to the development of various diseases. This study aimed to examine the effects of digital exercise intervention using artificial intelligence (AI) on the physical abilities of adults whether digital exercise intervention can be a reliable and effective therapeutic option for musculoskeletal disorders in real-world clinical settings. Methods : In this study, exercise was conducted using a digital application to investigate the effects of an AI-based digital exercise intervention on the physical abilities of adults. A total of 13 adults were evaluated, and their physical abilities before and after the exercise intervention were compared. Hand-grip strength, functional leg muscle strength, dynamic balance, and quadriceps muscle strength were assessed. Exercise was performed using a digital application and in a non-face-to-face manner. AI identified the exercise status of each participant and adjusted the exercise difficulty level accordingly. The exercised daily for 4 weeks. Results : A total of 12 participants were analyzed for the final results. Significant improvements were observed in hand-grip strength, functional leg muscle strength (evaluated using the stand-up test), dynamic balance, and straight-gait ability (p<.05), indicating an increase in the overall muscular strength and physical function of the participants. Conclusions : Digital exercise intervention using AI is effective in improving physical abilities related to musculoskeletal function. It can be useful in clinical practice as an effective treatment option for patients with musculoskeletal disorders or muscle weakness.
Proper nutritional management during the dry period is required to prevent metabolic disorders during the time of parturition and for potential increase milk yield during early lactation, especially under the heat of summer. The effect of prepartum diets on partitioning of nitrogen (N), calcium (Ca), phosphorus (P), magnesium (Mg) and potassium (K) during dry period and early lactation in summer was investigated. Nine cows were assigned to two groups and fed either control (group C: four cows) or high concentrate (group H: five cows) diets to meet 110% of their requirements before parturition. The proportion of concentrate in control diet was 35%, and that in the high concentrate diet was 45%. After parturition, all cows were fed the same diets ad libitum during lactation. Balance trials were conducted at 9, 8 and 7 days before parturition and at 12, 13 and 14 days after parturition. Before parturition, dry matter intake (DMI), DM and NFE digestibility in group C tended to be lower than those in group H. The retention of N (p<0.01) and P (p<0.05) in group C during the dry period was significantly lower than those in group H. The retention of Mg in group C during the dry period tended to be lower than in group H. The concentration of plasma NEFA in group C tended to be higher than in group H during dry period. The prepartum diet did not have an apparent effect on DMI and milk yield at 2 weeks after parturition and N, Ca, P, Mg and K balance after parturition.
An, Tae-Geun;Lee, Han-Suk;Park, Sun-Wook;Seon, Hee-Chang
대한물리의학회지
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제15권4호
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pp.11-20
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2020
PURPOSE: This study examined the effects of Nordic walking on depression and the physical function of elderly patients with a high risk of depression. METHODS: This study was a blinded randomized allocation study; 32 elderly were assigned to a Nordic walking group (n = 17), consisting of 60 min Nordic walking (including warming up 5 min, warming down 5 min, and Nordic walking 50 min) two days per week for 12 weeks and general leisure group (n = 15), consisting of 60 min leisure program community center. The pre and post 12-week program, depression test, muscle strength (including grip test, and 30sec sit to stand), and balance (including Functional Reach test, and One Leg Standing test) were measured. A Mann-Whitney U test was used to compare within the group, and a Wilcoxon signed-rank test was used to compare between the groups. RESULTS: After 12 weeks, only the Nordic walking group showed significant improvement in depression, muscle strength, and balance (p < .05). In the general leisure group, however, the left grip strength and Functional Reach Test (FRT) showed a significant decrease. The Nordic walking program was better than the general leisure group, and a significant difference was observed in depression, muscle strength, and balance between the two groups (p < .05). CONCLUSION: Nordic walking was effective for the elderly with a high risk of depression. Therefore, Nordic walking may be an option for preventing elderly mental disorders and functional improvement.
Purpose : Low back pain (LBP) is reported as a risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. The lumbar spine in an unstable state causes imbalance and lumbar instability. Therefore, This study examined the effects of lumbar stabilization exercise and self-complex exercise program on pain, function, psychosocial level, static balance ability, and transverse abdominal muscle (TrA) thickness and contraction ratio in patients with lumbar instability. Methods : The design of this is a randomized controlled trial (RCT). Twenty-six LBP patients participated in this study. Screening tests were performed and assigned to the experimental group (n=13) and control group (n=13) using a random allocation program. Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the self-complex exercise program. All interventions were applied three times per week for four weeks. The quadruple visual analog (QVAS), the Korean version of the Oswestry disability index (K-ODI), Korean version of fear-avoidance belief questionnaire (FABQ), static balance ability, TrA thickness, and contraction ratio were compared to evaluate the effect on intervention. Statistical significance was set at 𝛼=.05. Results : Both groups showed significant differences before and after the intervention in QVAS, K-ODI, FABQ, static balance ability, and TrA thickness in contraction (p<.05). In addition, significant differences in K-ODI and FABQ were observed between the experimental group and control group (p<.05). Conclusion : A lumbar stabilization exercise and self-complex exercise program resulted in reduced dysfunctions, psychosocial stability in patients with lumbar instability. Therefore, Lumbar stabilization exercise and self-complex exercise program for patients with lumbar instability are effective method with clinical significance in improving the function and psychosocial stability.
Since areas of pain and dysfunction of musculoskeletal typically suffered by the patients with back disorders spread all over the body, WBIP(GCM Program) for the primary treatment and management is required. The purpose of this study is to analyze if WBIP(GCM Program) based on the hyper/hypomobility pattern of Four Body Types can identify the effective treatment of back disorders and the effect on the postural balanced restoration of the spine and extremities. Non-specific back disorder is still a major reason for sick leave. And moreover, its been reported that there was often recurrence to the patients whose symptom had been diminished. As a WBIP(GCM Program) based on kinematic chain patterns of Four Body Types, this study gave a new information on the effective diagnosis, treatment and management of non-specific back disorders. 337 patients above the twenty-five years old with the non-specific back disorders at the hospital and oriental medical clinics at Kyungnam and Busan areas in South Korea from August 24th, 2000 to Feb 23rd, 2001 have randomly been assigned to four experimental groups such as Whole Body Intervention Program Group, Physical Therapy Group like modality treatments, Acupuncture-Treatment Group, and Placebo Control Group. According to intervention program applied to the each four group for three times per week(twelve times per 4weeks), as the time-series methods, we compared and evaluated the body status of the pretest with that of post treatment completion of four week, three month, and six month, respectively. As the analytical method of measurement, our researchers used the Moire Interferometry Unit and Postural Kit that could measure the postural balance of spine and extremities. The collection of data was performed in the designated hospital and oriental medical clinics. For the analysis of the data, the SPSS 10.0 package program was used. X2-test has been taken in order to compare and analyze characteristics and GPES of the patients in four experimental groups. Repeated Measure ANOVA and Tukey post hoc test has been adopted in order to compare the effects of the balanced restoration of the spine and extremities among four Groups categorized for this study. Statistical significance was accepted at the 0.05 level of confidence The effect of the balanced restoration on the spine and extremities of the patients with non-specific back disorders has been proved in all of the Groups. As for the restoration degree, however, WBIP(GCM Program) Group produced the highest effectiveness in terms of the fact that it had a dense moire in comparison with the other three Groups and that the Moires of both sides had the same level by the time(p<0.01). WBIP(GCM Program) based on four tilting types of scapular and ilium and hyper/hypomobility pattern took a higher effect on the balanced restoration of the spine and extremities through a whole body as well as the treatment of back disorders than the other three Groups which the usual remedy without classification of body type had been applied to.
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