• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.66-77
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• 2022

Objective: This study is a systematic review conducted to analyze the environmental factors that cause falls in the older adult. Design: Systematic review Methods: The study was conducted by searching the Research Information Sharing Service (RISS), Korean studies Information Service System (KISS), and Data Base Periodical Information Academic (DBpia) databases for literature published in South Korea up to July 2020. A total of 12 studies were selected for analysis based on the inclusion and exclusion criteria. Results: The results of the analysis revealed that all the selected literature were surveys and the study subjects were 65 years of age and above. The sample size ranged from a minimum of 95 subjects to a maximum of 3,278. A total of eight tools were used to measure the environmental factors associated with falls. The prevalence and recurrence of falls increase with age and deterioration of health. Older adult individuals who experience falls encounter difficulties in recovering from impaired physical function and disability; moreover, in severe cases, falls may lead to death. Falls are largely associated with a combination of intrinsic and extrinsic (i.e., environmental) factors. The purpose of this study was to assess potential extrinsic risk factors for falls. Falls occur in indoor environments, such as washrooms, bathrooms and living rooms, and outdoor environments, including roads and stairways, depending on the season, time of day, and use of ambulatory aids. In such environments, falls are mainly caused by slipping and stuttering. Conclusions: Therefore, as the rate of fall is influenced by several factors, extrinsic factors should be improved by developing comprehensive accident prevention programs that address the improvement of environmental risk factors around places of residence to reduce risk factors among the older adult, who, especially, are at a high risk for falls.

• 대한정형도수물리치료학회지
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• 제29권3호
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• Journal of Acupuncture Research
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• 제26권5호
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• pp.171-181
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• 2009

Objectives : A ruptured disc is a condition in which part or all of the nucleus pulposus is forced through a weakened part of the disc, resulting in back pain and leg pain caused by nerve root irritation. In this report, we investigated the effect of oriental medicine treatment in parallel with sling exercise therapy on ruptured intervertebral lumbar disc patients. Methods : The patients who have ruptured disc were treated by oriental medicine treatment in parallel with sling exercise therapy. The patients' symptoms were assessed by visual analogue scale(VAS) and revised oswestry disability questionnaire(RODQ) every week. Results : In all cases, chief complain such as lumbago, radicular pain and paresthesia were improved after above treatment. VAS score and RODQ score of all cases were decreased. Conclusions : There were usually thought to need operation in ruptured disc. But conservative treatment such as oriental medicine treatment in parallel with sling exercise therapy is helpful to improve the symptoms of the ruptured intervertebral lumbar disc except the emergency state.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.1-11
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• 2018

Background: The continuous co-contraction of the trunk muscles through trunk stabilization exercises is important to patients with lumbar spinal stenosis (LSS). However, intentional abdominal muscle contraction (IAMC) for trunk stabilization has been used only for specific training in the treatment room. Objects: The purpose of this study was to provide feedback to adults with LSS to enable IAMC during activities of daily living (ADLs). Methods: The participants with spinal stenosis were divided into an experimental group of 15 adults and a control group of 16 adults. Electromyographic signals were measured while the subjects kept their both hands held up at $90^{\circ}$. The measured muscles were the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES). Pelvic tilt was measured using a digital pelvic inclinometer. The degree of pain was measured using the visual analogue scale (VAS) and functional capacity was measured using the Korean version of the Oswestry disability index (KODI). Results: While the experimental group showed statistically significantly higher activities in the RA, EO, and IO after the intervention compared with the control group. Pelvic tilt was significantly decreased only in the experimental group. Both the experimental and control groups exhibited statistically significant declines in the VAS and KODI (p<.01). In terms of the levels of changes, the experimental group exhibited a statistically significant larger decline only in the VAS and the pelvic tilt when compared with the control group (p<.05). Conclusions: The subjects could stabilize their trunks, and relieve their pain and dysfunctions and reduce pelvic tilt by learning abdominal muscle contraction during ADLs. The combination of therapeutic exercises and IAMC may have greater effects on patients with LSS.

• 한국전문물리치료학회지
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• 제28권2호
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• pp.93-100
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• 2021

Background: Lateral epicondylitis (LE) is the most common chronic musculoskeletal conditions of the upper extremity with pain and wrist extension disability. The tendon which is most affected is the extensor carpi radialis brevis (ECRB). Previous study evaluated the effect of taping technique on patient with LE, but no study investigated the changes of electromyography (EMG) on ECRB when using dynamic taping (DT) technique. Objects: The aim of this study was to investigate the effect of DT technique using dynamic tape on muscle activity of ECRB during wrist isometric extension, isotonic extension and flexion. Methods: Twenty-one healthy subjects volunteered to participate in this study. Subjects were instructed to perform wrist isometric extension, isotonic extension and flexion without and with DT on origin area of ECRB. Wrist isometric extension was performed at 75%, 50% and 25% (%maximal voluntary contraction force), respectively, based on maximum contraction force. Isotonic extension and flexion test used dumbbell. EMG data was collected from ECRB. Results: EMG of ECRB were statistically significant decrease in wrist isotonic extension after DT (p < 0.05). Significant increase in wrist isometric extension during 25% and 50% force task (p < 0.05). Conclusion: This study applied DT technique to suppress the wrist extensor muscles in 21 healthy adults in their twenties. Change in muscle activity was compared in the ECRB muscle during wrist isometric extension, isotonic extension and flexion task. Based on the results of this study, the DT technique applied to the wrist and forearm area can reduce the load on the wrist extensors when the wrist performs various movements during daily life movements or repetitive tasks, and by using these effects, excessive stress is applied to tennis elbow patients.

• 한국엔터테인먼트산업학회논문지
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• 제14권2호
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• pp.225-235
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• 2020

본 연구는 골다공증 환자의 라이프 케어 증진을 위한 미충족 의료실태와 위험요인 분석하기 위하여 패널 자료를 활용한 횡단적 2차 분석 조사연구이다. 연구대상자는 한국의료패널 2015년 자료(β-version 1.0)를 활용하여 골다공증 진단을 받은 941명을 대상으로 하였다. SPSS/win 22.0 Program을 이용하여 χ² test, logistic regression을 이용하여 자료를 분석하였다. 연구결과 골다공증 환자의 미충족 의료 발생률은 22.6%이었으며, 인구학적 특성 요인의 Model I에서는 나이, 교육수준으로 나타났으며, 신체적 요인을 추가한 Model II에서는 섭식문제, 기억력 장애, 활동제한, 장애 판정으로 나타났다. 심리·사회적 요인을 추가한 Model III에서는 섭식문제, 기억력 장애, 총 가구 소득, 통증/불편감으로 확인되었다. 본 연구 결과를 바탕으로 골다공증 환자의 라이프 케어를 증진시키기 위해 지속적으로 의료정책 기획 시 고려되어져야 하겠으며, 미충족 의료를 감소시키기 위한 의료서비스 접근성 개선과 현실적인 예방 및 중재가 필요하겠다.

• 대한정형도수물리치료학회지
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• 제29권3호
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• pp.73-84
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• 2023

Background: This study aimed to compare pressure pain thresholds (PPTs) in the vertebral segments between patients with chronic lower back pain (CLBP) and healthy participants without back pain and to determine the correlation between vertebral bone-segment PPT and pain level, lower back pain dysfunction, and psychological status in patients with CLBP. Methods: The subjects of this study were 23 healthy adults and 23 adults with CLBP. PPT was measured in 23 spinal bone segments using a PPT device, and the CLBP group was subjected to a pain level test (NRS) and a psychological test using the Korean version of the pain catastrophizing scale (KPCS). The functional level was assessed using the Korean version of the Oswestry disability index (KODI). Results: PPTs of the spinal sclerotomes were significantly lower in patients with CLBP than in healthy participants. In the CLBP group, the composite score of lumbar PPTs showed a high correlation with the composite scores for all segments, but not with the pain level (NRS), KPCS score, and spinal sclerotome PPT. Moreover, PPT in the sacral sclerotomes showed a significant negative correlation coefficient with function, with a KODI score of -.462 (p<.01). Conclusion: In this study, PPTs in all spinal segments in patients with CLBP was significantly lower than that in healthy subjects. The PPTs of the lumbar region was significantly correlated with the PPTs of other spinal regions. Through this study, it was found that there were changes in PPTs in CLBP patients not only in the lumbar region but also in other spinal regions. This information should be considered during clinical treatment of patients with low back pain.

• 한국전문물리치료학회지
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• 제25권4호
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1600-1605
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• 2000

Objective : World Health Organization and International Labour Organization, in June 8, 1999, requested that working conditions should be reformed ethically right and economically solid for 2.7 billion world labour force. The purpose of this study is to request compensable surgical therapeutic options and to suggest the renewal in cognizance criteria for worker's compensation, especially in spondylolisthesis. Methods : Regarding spondylolisthesis, we obtained data from Korea Labor Welfare Corporation(KLWC). Spinal disease occurrence incidences and medical fees of National Federation of Medical Insurance(NFMI) were analysed. The compensated 122 spinal instrumented cases included 117 male and 5 female patients, aged from 23 to 72 years old(mean : $45{\pm}9.85$). We compared Korean and Foreign Workers Compensation Law. Results : Numbers of herniated nucleus pulpus(78 cases), spinal fractures(34 cases) and dislocations(4 cases) were claimed after spinal interbody fusion operation and were compensated. These compensated degenerative diseases, work related illness, occurred in the course of work. A case of 52-year old spondylolisthesis patient with Disability Grade 8 was compensated by KLWC, according to its occurrence at work by accident. With exception of trauma at work by accident, current cognizance criteria were too narrow to be compensable, especially in surgical therapeutic option, for worker's spondylolisthesis. Conclusion : Considering both worker's compensation law and clinical pathologic progress, we believe that spondylolisthesis should be regarded as a compensable occupation related disease if and when aggravates rapidly in the course of work. We suggest a new cognizance standard to KLWC for labour welfare and proper worker's compensation.

• Journal of Preventive Medicine and Public Health
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• 제27권2호
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• pp.299-312
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• 1994

This survey was performed to obtain the basic information for the prevention and management of occupational low back injury (LBI). The subjects of this survey were 952 workers (male, 892 ; female, 60) who had taken occupational LBI in some industries of Pusan area from January 1 to December 31, 1991. Observation period was 2.6 years from the beginning to the end of medical treatment. The obtained results were summarized as follows ; 1. The proportion of LBI workers was 15.9% of the workers who had taken any occpational injuries and 0.32% of all workers in this surveyed area. 2. 8.0% of the workers had taken LBI on the 1st day of employment and 55.2% of the workers were within one year, 91.4% of the workers were within 10 years according to cumulative frequency distribution. 3. Handling of heavy objects was the most common cause of LBI (32.0%) and fall down (26.9%) and slip down (16.3%) were the next in order. 4. The most common causes of both lumbar sprain and HNP were handling of heavy objects and that of lumbar fracture was fall down. 5. The mean duration for medical treatment of LBI workers was 143 days. 6. The total direct compensation cost for LBI workers was 6,736 million Won and the proportion of medical, resting, disability compensation costs were 25.0%, 37.0%, 38.0 % respectively. 7. The percentages of retreated workers and disabled workers were 11.9% (113 persons) and 22.9% (218 persons) of total LBI workers respectively.