• Title/Summary/Keyword: Clinical practice pattern

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The Effects of Proprioceptive Neuromuscular Facilitation (PNF) Using Elastic Bands on Edema, Range of Motion, and Pain in Post-Mastectomy Patients with Upper Limb Lymphedema: Differences between Open-Hand and Closed-Hand Grips (탄력밴드를 이용한 PNF 운동이 유방암 절제술에 속발한 상지 림프부종 환자의 부종, 관절가동범위 및 통증에 미치는 영향 -열린 홀딩과 닫힌 홀딩의 차이-)

  • Jo, Ye-Jin;Lee, Sang-Yeol
    • PNF and Movement
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    • v.18 no.1
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    • pp.1-10
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    • 2020
  • Purpose: This study was conducted to examine the effects of a PNF intervention using elastic bands on edema, range of motion (ROM), and pain in post-mastectomy patients with upper limb lymphedema, according to their hand grip type. Methods: The subjects were 14 female patients who were at Stage II lymphedema after undergoing mastectomy for Stage II breast cancer. They were randomly divided into an experimental group (n =7) and a control group (n = 7). Both groups participated in a treatment program four times (one time under the therapist's instructions and three times as self-exercise) a week for 4 weeks. Both groups repeated an upper limb PNF pattern exercise for 30 min using elastic bands after receiving a manual lymph drainage treatment for 1 hour. Here, subjects in the experimental group performed the PNF exercise with an open-hand grip by putting their hands into the loops of elastic bands and keeping their fingers spread out. Subjects in the control group performed the PNF exercise with a closed-hand grip by holding the loops of elastic bands with their fingers. In both groups, the subjects' edema, ROM, and pain levels were measured before the intervention and 2, 3 and 4 weeks after the intervention. Results: As a result of the experiment, both groups demonstrated edema reductions, ROM increases, and pain reductions in four areas of the upper limbs. Notably, the experimental group exhibited larger ROM increases in flexion, extension, and abduction as well as greater edema and pain reductions than the control group. In particular, the most significant effects were found in the elbow of the four upper limb areas for edema reductions and in extension for ROM increases. Conclusion: The present study indicates that exercise therapy-based approaches using elastic bands in post-mastectomy patients with upper limb lymphedema can have different effects depending on the type of hand grip (open or closed), which is the body's most distal part. Therefore, these approaches should be based on the conditions of the distal parts of the patient's body for their effective applications in clinical practice.

Psychogenic Dizziness for Psychiatrists in Korea (정신건강의학과 의사를 위한 심인성 어지럼)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.9-19
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    • 2016
  • Many patients with dizziness present with a symptom pattern that does not reveal the cause by neurotologic diagnostic approaches. In such cases, the physician frequently diagnoses psychogenic dizziness. Psychogenic dizziness is not characterized by true vertigo, and occurs in combination with other psychiatric symptom cluster. One out of two to four patients with dizziness are psychogenic dizziness. But there are few concern about this including clinical practice and study in Korea. I wrote this paper to increase concerning and attending to this for psychiatrists in Korea. I reviewed etiology including biological and psychological relations between dizziness and psychiatric disorder(especially anxiety), diagnostic approaches of, characteristics of dizziness of various psychiatric disorders related to, and the treatment of psychogenic dizziness. I also briefly reviewed the central and peripheral dizziness for psychiatrists. I suggest psychiatrists and clinicians in the psychosomatic field in Korea to acknowledge, concern, and attend to psychogenic dizziness. In turn, it will be helpful to well treat the patients with psychogenic dizziness.

The Heterogeneous Trajectories of Functional Disability in Older Adults and Their Predictors (노년기 기능장애의 이질적 발달궤적과 예측요인)

  • Lee, Hyunjoo
    • 한국노년학
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    • v.37 no.1
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    • pp.15-32
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    • 2017
  • The current study aims to identify the heterogeneous changes of functional disabilities in old age rather than to identify an average longitudinal pattern and to explore the effect of health status and social status as risk factors in functional disability trajectories. The sample consisted of a representative sample of community dwellers aged 65 and older from the Korean Longitudinal Study of Ageing (2006 - 2012) was the focus of the study. Latent Class Growth Analysis was used to identify the functional disability trajectory groups. Variables regarding health status and social status changes by class were identified using multinomial logistic regression. The results showed various change patterns in functional disability, which include independent (78%), stable high (4.4%), steeply increasing (7.1%), slightly increasing (5.5%), and moderate to low (4.7%). Aggravation in depressive symptoms and cognitive functions as well as decline in social participations and social engagements were significant predictors of membership in increasing group of functional disability. The findings provide important initial empirical information to target clinical practice and have implications in the importance of conducting research on groups with different characteristics.

Voice range profile in premutation, mutation, and postmutation of men (변성이전, 변성 및 변성이후 남성의 발성범위 프로파일)

  • Kim, Jaeock;Lee, Seung Jin
    • Phonetics and Speech Sciences
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    • v.13 no.4
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    • pp.89-100
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    • 2021
  • This study compared the voice range profiles (VRPs) with glissando and simplified VRP methods with 57 men who were in premutation (8-13 years), mutation (11-16 years), and postmutation (10-24 years) stages. The difference between modal and falsetto areas measured in two VRP methods was also compared. As the results, the average fundamental frequency (F0) was in the order of premuaton>mutation>postmutation. The maximum F0 (F0max), the range of F0 (F0range), the maximum intensity (Imax), and the range of intensity (Irange) were the lowest in the mutation stage, and these variables were higher in falsetto area than in modal area in both methods. In addition, most variables of VRP in glissando were higher than in simplified VRP, but the differences were not significant. This study showed that, in men in mutation stage, due to the temporary anatomical and physiological changes of the larynx, the mechanism of the vocal folds vibration changes and VRP shows a different pattern from that of other age groups. Both the VRPs of glissando and simplifed VRP are suitable for clinical practice by experienced examiners. And it is necessary to measure not only the falsetto area but also the modal area when measuring VRP.

Reliability Analysis of Finger Joint Range of Motion Measurements in Wearable Soft Sensor Gloves (웨어러블 소프트 센서 장갑의 손가락 관절 관절가동범위 측정에 대한 신뢰도 분석)

  • Eun-Kyung Kim;Jin-Hong Kim;Yu-Ri Kim;Ye-Ji Hong;Gang-Pyo Lee;Eun-Hye Jeon;Joon-bum Bae;Su-in Kim;Sang-Yi Lee
    • PNF and Movement
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    • v.21 no.2
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    • pp.171-183
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    • 2023
  • Purpose: The purpose of this study was to compare universal goniometry (UG), which is commonly used in clinical practice to measure the range of motion (ROM) of finger joints with a wearable soft sensor glove, and to analyze the reliability to determine its usefulness. Methods: Ten healthy adults (6 males, 4 females) participated in this study. The metacarpophalangeal joint (MCP), interphalangeal joint (IP), and proximal interphalangeal joint (PIP) of both hands were measured using UG and Mollisen HAND soft sensor gloves during active flexion, according to the American Society for Hand Therapists' measurement criteria. Measurements were taken in triplicate and averaged. The mean and standard deviation of the two methods were calculated, and the 95% limits of agreement (LOA) of the measurements were calculated using the intraclass correlation coefficient (ICC) and Bland-Altman plot to examine the reliability and discrepancies between the measurements. Results: The results of the mean values of the flexion angles for the active range of motion (AROM) of the finger joints showed large angular differences in the finger joints, except for the MCP of the thumb. In the inter-rater reliability analysis according to the measurement method, the ICC (2, 1) value showed a low level close to 0, and the mean difference by the Bland-Altman plot showed a value greater than 0, showing a pattern of discrepancy. The 95% LOA had a wide range of differences. Conclusion: This study is a preliminary study investigating the usefulness of the soft sensor glove, and the reliability analysis showed a low level of reliability and inconsistency. However, if future studies can overcome the limitations of this study and the technical problems of the soft sensor glove in the development stage, it is suggested that the measurement instrument can show more accurate measurement and higher reliability when measuring ROM with UG.

The Comparison of ICSD and DSM-Ⅳ Diagnoses in Patients Referred for Sleep Disorders (정신과에 의뢰된 환자 중 수면장애에 대한 ICSD와 DSM-Ⅳ 진단 비교)

  • Lee, Bun-Hee;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.37-44
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    • 2001
  • Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

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