• 대한정형도수물리치료학회지
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• 제11권1호
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• pp.11-28
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• 2005

Spasticity has been defined as "a motor disorder characterized by a velocity-dependent increased in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one components of the upper motorneuron syndrome". Spasticity is one of the common symptoms of stroke patients and frequently interferes with the motor functions such as gait, posture and activities of daily living. Therefore, its management is becoming a major issue in physical therapy. The purpose of this study was to determined the effects of reciprocal inhibition by isometric contraction of pre-tibia muscle on spasticity in hemiplegic patients through Hoffmann reflex. The subjects were consisted 45 patients who had hemiplegia due to stroke. All subjects randomly assigned to 3 group: manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not received any therapeutic intervention. Before and after experiments, Hoffmann reflex, M-wave and Modified Ashworth scale was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. Modified Ashworth scale were significantly decreased after experiment in manual group(p<.01). The Hmax/Mmax ratios were significantly decreased after experiment in manual group(p<.o1). There were no statistical difference between pre-test and post-test with modified Ashworth scale in NMES group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in NMES group(p>.01). There were no statistical difference between pre-test and post-test with modified Ashworth scale in control group(p>.01). There were no statistical difference between pre-test and post-test with Hmax/Mmax ratios in control group(p>.01). The present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be reduce spasticity of gastrocnemius. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyse the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

• 한국방사선학회논문지
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• 제14권7호
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• pp.915-922
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• 2020

본 연구는 경남지역에 근무하는 방사선사를 대상으로 방사선사의 스마트폰 이용에 따른 이용성향과 중독에 관한 내용으로 분석하였다. 연구의 자료로 사용한 도구는 설문지로 2019년 04월21일부터 05월31일까지 경남에 소재하는 의료기관에 근무하는 방사선사를 대상으로 설문지 총 330부를 배부하여 연구에 적합한 300부를 SPSS/PC Ver 18.0 프로그램을 이용하여 분석하였다. 연구대상자의 스마트폰 이용성향 요인으로는 의사소통, 정보, 여가, 편의성으로 하였으며, 중독요인으로는 일상생활장애, 가상세계지향, 내성, 금단으로 총 37문항으로 분석하였다. 일반적 특성으로 성별, 연령대, 학력, 근무기관, 근무부서를 기준으로 하였으며, 스마트폰 관련 특성으로는 월평균요금, 사용시간, SNS사용시간으로 기술통계, t-test, ANOVA, 상관관계및 회귀분석을 하였다. 방사선사의 스마트폰 이용성향은 3.10±.55점으로 평균정도로 나타났으며, 스마트폰 중독은 2.34±.62점으로 평균보다는 낮게 나타났다. 방사선사의 스마트폰 이용성향 및 중독은 유의한 상관관계가 있는 것으로 나타났으며, 방사선사의 스마트폰 이용성향이 중독에 미치는 영향에 대해서는 10.8%를 설명하는 것으로 나타났다. 본 연구를 통하여 방사선사의 스마트폰 이용성향에 따른 중독요인을 분석하여, 스마트폰 사용에 대한 바람직한 방안을 마련하는 것이 중요하다고 할 수 있다.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.128-148
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• 2023

Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

• 한국보건간호학회지
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• 제16권1호
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• pp.77-94
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

• 지역사회간호학회지
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• 제10권2호
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• pp.435-454
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• 1999

The caregiving experiences of 100 family menbers of outpatients with schizophrenia and schizoaffective disorders were investigated for the presence of positive(positive family-patient relationship. patient' contribution to the family) and negative caregiving experience(objective and subjective burden) and their predictors. This study attempts to make the analysis of caregiving experience more useful by expanding the focus to incoporate these positive aspects of the experience of family caregiver. Objective burden consists of two elements: 'disruption of family life', 'care'(amount of caregiving related to activity of daily living). Subjective burden is defined as emotional reactions to the care giving and it comprised of 6 emotional subdimensions such as 'stigma', 'grief'. 'worry', 'pity', 'fear', 'despair'. Also we investigate the severity of patients' disturbing behaviors into two categories, positive and negative disturbing behaviors and patient' contribution to the family as a predictors of positive and negative caregiving experiences. This study use Pearson's correlation coefficient, Hierardhical regressions in the SAS Program. The results are as follows: 1. Respondents reported moderate level of objective burden 'disruption of family life' (mean = 2.48, range = 1-4), and 'care' (mean=2.54, range = 1-4), and slightly high level of total subjective burden(mean = 2.19, range = 1-4). Mean scores for the measure of the severity of behavioral disturbance indicated that the caregiver experienced negative disturbing behaviors around almost 'somtimes'(mean=2.28, range = 1-4), and positive disturbing behaviors 'almost not frequent'(mean=2.78. range=1-4). So they reported that they perceived patient's negative disturbing behaviors more than positive disturbing behaviors. Mean scores for the measure of the patient' contributions (mean = 1.99. range = 1-4) indicated that caregivers experienced these contributions a little. It means that there should be a positive aspect of possibilities of patient' family roles that can be developed in the daily life. Mean scores for the measure of the positive family-patient relationship indicated that caregivers experienced moderate level of positive family-patient relationship(mean=2.52, range = 1-4). 2. Hierardhical regression analysis 1) Hierardhical regression of 'disruption of family life' showed that the interaction between positive disturbing behaviors and patient' contributions (B = .20. p = .022) and caregiver's educational level(B=.06. p=.000) were 'significant and Hierardhical regression of 'care' showed that 'negative disturbing behaviors'(B= .35. p= .007). 'patient' contributions'(B= .28, p= .019). 'family income'(B=-.l1. p=.096) were significant. 2) Hierardhical regression of 'total subjective burden', 'stigma', 'grief', 'worry', 'pity'. 'fear', 'dispair' showed that 'positive disturbing behaviors'(B=.51. p=.000). 'negative disturbing behaviors' (B = .17, p = .026), 'caregiver's educational level'(B = .03. p=.036), 'family income'(B=.08. p=.041) were significant predictors of 'total subjective burden': 'positive disturbing behaviors'(B=.32. p=.066). 'negative disturbing behaviors'(B=.24, p=.096) 'durations of illness'(B= .03. p= .079) were significant predictors of 'stigma' 'negative disturbing behaviors'(B=.28. p=.005). 'patient sex'(B=-.32. p=.022). 'positive disturbing behaviors'(B=.28. p=.020), 'patient age'(B=.02. p=.010), 'caregiver age'(B=-01, p= .002) were significant predictors of 'grief' 'negative disturbing behaviors'(B= .28, p= .005). 'patient sex'(B= -.32. p=.039), 'caregiver age'(B=-.02, p= .023). 'caregiver's educational level'(B= .04, p = .044) were significant predictors of 'worry' 'patient sex'(B=-.46. p=.005). 'negative disturbing behaviors'(B= .28. p=.018), 'caregiver age'(B=-.01, p=.037) were significant predictors of 'pity' 'positive disturbing behaviors'(B=.83. p=.000). 'patient' contributions' (B = .22, p =.017). 'family income'(B=.09. p=.65) were significant predictors of 'fear' 'positive disturbing behaviors'(B=.49, p=.001). 'negative disturbing behaviors'(B= .24. p=.057) 'patient sex'(B=-.4l, p=.017), 'family income'(B=.14, p=.047) were significant predictors of 'dispair'. 3) Hierardhical regression of 'positive relationship' showed that 'patient contributions'(B=.32, p=.000). 'negative disturbing behaviors'(B= .24, p= .005), 'patient sex'(B=-.23, p=.036).