• 제목/요약/키워드: Disability and Health

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The relationship between disability and clinical outcomes in maintenance dialysis patients

  • Kang, Seok Hui;Do, Jun Young;Kim, Jun Chul
    • Journal of Yeungnam Medical Science
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    • 제38권2호
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    • pp.127-135
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    • 2021
  • Background: Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients. Methods: This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization. Results: The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend). Conclusion: Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

고유수용성신경근촉진법 호흡근 강화 운동이 만성 허리통증 환자의 폐 기능과 장애 수준에 미치는 영향 (The Effect of Proprioceptive Neuromuscular Facilitation Respiratory Muscle Strengthening Exercise on Pulmonary Function and Disability Level in Chronic Low Back Pain Patients)

  • 김혜미;강태우;김범룡
    • PNF and Movement
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    • 제19권1호
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    • pp.57-65
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    • 2021
  • Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) respiratory muscle strengthening exercise on the pulmonary function, back pain, and disability level of patients with chronic low back pain (CLBP). Methods: There were 24 CLBP patients randomly divided into the experimental group (n = 12) who took part in PNF respiratory muscle strengthening exercise and the control group (n = 12) who performed a mock treatment. Both groups performed their respective interventions for 15 min five times per week for four weeks. The pulmonary function was measured using a portable spirometer. The back pain of the participants was assessed using a visual analogue scale. The Oswestry disability index was conducted to measure disability level. A paired t-test was performed to compare within-group changes before and after the PNF respiratory muscle strengthening exercise. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: The within-group change in pulmonary function was significantly different in the experimental group (p < 0.05), and the levels of back pain and disability were significantly different between the groups (p < 0.05). There was also a significant between-group difference in pulmonary function, back pain, and disability level after intervention (p < 0.05). Conclusion: These results suggest that PNF respiratory muscle strengthening exercise enhances pulmonary function and reduces levels of back pain and disability in patients with CLBP.

경통 환자들을 위한 Neck Pain and Disability Scale의 신뢰도 연구 (Reliability of the Neck Pain and Disability Scale in Neck Pain Patients)

  • 신원섭;이은우;정경심;이석민;정이정
    • 한국전문물리치료학회지
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    • 제15권1호
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    • pp.77-85
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    • 2008
  • The self-report measure is a useful tool for evaluating self-recognized disability and difficulty in daily living activities. Although many studies and clinics used the Neck Pain and Disability Scale (NPDS) for measuring neck pain and functional impairment, there has not been much adaptation of this for use with Korean patients. The purpose of this study was to establish the reliability and validity of NPDS among Korean neck pain patients. Fifty-five subjects (32 males, 23 females) with neck pain enrolled in this study. They completed standardized self-administered questionnaires. The NPDS measures pain intensity; its interference with vocational, emotional, recreational, social, and functional aspects of living; and the presence and extent of associated factors. Reliability was determined by the intraclass correlation coefficient (ICC) and Cronbach's alpha for internal consistency. Validity was examined by correlating the NPDS scores to the Visual Analog Scale (VAS) score. The test-retest reliability of the translated versions of the NPDS was good ICC (2,1)=.86 (95%CI .76~.92). Cronbach's alpha value for NPDS was found to be .93, and this was statistically significant (p<.05). The criterion-related validity coefficient was .79 (p<.Oll. We conclude that the Korean version of NPDS has been shown to be a reliable and valid instrument for the assessment of neck pain. Successful linguistic and cultural translation will admit appropriate cross-cultural comparison for clinical analysis. Therefore, this study can be expected to be used as an adequate evaluation scale for neck pain related studies and treatments.

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원시반사통합운동이 신경발달장애 아동의 앞쪽머리자세, 균형능력, 주의집중력에 미치는 효과 : 예비연구 (Effects of Primitive Reflex Integration Exercises on Forward Head Posture, Balance, and Concentration in Children with Neurodevelopmental Disability : A pilot study)

  • 정지웅;최한;함석찬
    • 대한통합의학회지
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    • 제9권4호
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    • pp.29-38
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    • 2021
  • Purpose : Therapeutic exercise should improve the health outcomes of rehabilitation in children with neurodevelopmental disability. The purpose of this study was to investigate the feasibility of primitive reflex integration exercises on forward head posture, balance ability, and concentration in children with neurodevelopmental disability. Methods : This study included 10 children with neurodevelopmental disability. Primitive reflex integration exercises were performed for 40 minutes, twice a week for 8 weeks (16 sessions). The reflective markers were placed at the center of the shoulders and on the ears. A caliper was used to measure the distance between the attachments of the reflective markers to assess the forward head posture. Pediatric balance scale was used to quantify balance ability. Their abilities in terms of changeless sitting, looking at the teacher, putting children's hands on their knees, and looking at immovable and movable objects, were assessed to quantify concentration. Results : There were significant improvements in forward head posture after the intervention (p=.005). Primitive reflex integration exercises significantly improved balance ability of children with neurodevelopmental disability (p=.027). There were also significant improvements in changeless sitting (p=.005), looking at the teacher (p=.004), putting children's hands on their knees (p=.005), and looking at the immovable (p=.004) and movable (p=.004) objects. Conclusion : This study showed that primitive reflex integration exercises were a useful intervention to improve forward head posture, balance, and concentration in children with neurodevelopmental disability. Therefore, primitive reflex integration exercises may also promote and improve their general development. Further studies with appropriate sample size and control group are needed to conclude the effectiveness of primitive reflex integration exercises on improving posture, motor function, and concentration in children with neurodevelopmental disability.

Morbidity, Disability and Death Rates of The Population Due to Malignant Neoplasms in Uralsk City in The Republic of Kazakhstan

  • Umarova, Gulmira;Mamyrbayev, Arstan;Bermagambetova, Saule;Baspakova, Akmaral;Satybaldieva, Umyt;Sabyrakhmetova, Valentina;Abilov, Talgar;Sultanova, Gulnar;Uraz, Raisa
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권12호
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    • pp.5159-5164
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    • 2016
  • Objective: The dynamics of morbidity, disability and death rates due to malignant neoplasms in the population in Uralsk city of the Republic of Kazakhstan were studied for 2011-2015, with a focus on age and sex, as well as tumor location. Methods: Statistics for total morbidity, primary disability and mortality from cancer in the adult population of the city of Uralsk for 2011-2015 were calculated per 100 thousand. Estimation of morbidity was based on data from form - $N{\underline{o}}12$ ${\ll}$Report on the number of diseases registered in patients living in the area of health care organizations and patient population under medical observation". Evaluation of primary disability was based on form $N{\underline{o}}7$ ${\ll}$The distribution of newly recognized disabled by disease class, age, sex and disability groups" for 2011-2015 in Ural city and analysis of cancer was carried out using annual form 7 "Report on the sick, and diseases of malignant neoplasms". Result: The most common localizations of cancer were the trachea, bronchi, lungs, stomach and mammary glands. High death rates were noted for patients with cancer of the trachea, bronchi, lung, as compared to stomach and esophagus. Conclusion: The results of our investigation and data in the literature indicate that regional characteristics influence the impact of risk factors associated with cancer. An unfavorable environmental background contributes to ill health of urban populations, contributing to development of cancer. Moreover behavioral risk factors are very important, such as smoking, alcohol drinking, and an unhealthy diet. All these factors require urgent adoption of a package of measures for prevention, early detection and timely treatment. Detailed study of cancer is necessary to develop national programs and activities for prevention and control.

A Correlation Study on Pain, Range of Motion of Neck, Neck Disability Index and Grip Strength after Thoracic Manipulation and Cervical Stabilization Training in Chronic Neck Pain

  • Kim, Sang Hak;Kang, Kyung Woo;Lee, Kwan Woo
    • The Journal of Korean Physical Therapy
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    • 제29권4호
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    • pp.158-163
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    • 2017
  • Purpose: The purpose of this study was to investigate the relationship among pain, range of motion of the neck, neck disability index and grip strength after thoracic manipulation and cervical stabilization training in patients with chronic neck pain. Methods: In this study, twelve subjects with chronic neck pain were included. All participants had thoracic manipulation and cervical stabilization training. Intervention was conducted three times per a week, for 4 weeks. The visual analogue scale (VAS), range of motion of neck, neck disability index (NDI), as well as the grip strength before and after intervention were measured in all participants. Paired t-test was used to compare variables before and after intervention. Pearson correlation analysis was used to identify the correlations between the variables. Results: All variables after the intervention were significantly improved. There was a significant negative correlation between VAS and flexion angle of the neck (r=-0.669, p<0.05). Moreover, there was a significant positive correlation between NDI and VAS (r=0.636, p<0.05), and a significant negative correlation between NDI and flexion angle of the neck (r=-0.692, p<0.05). Conclusion: Patients with reduced pain following therapeutic intervention illustrated that there would be an improvement in the flexion angle rather than the extension angle of the neck, and that those with increased flexion angle would have less restriction of activities in daily living.

Obesity as a Possible Risk Factor for Lost-time Injury in Registered Nurses: A Literature Review

  • Jordan, Gillian;Nowrouzi-Kia, Behnam;Gohar, Basem;Nowrouzi, Behdin
    • Safety and Health at Work
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    • 제6권1호
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    • pp.1-8
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    • 2015
  • Time-loss injuries are still a major occurrence in Canada, injuring thousands of Canadian workers each year. With obesity rates on the rise across the country, as well as around the world, it is important that the possible effects of obesity in the workplace be fully understood, especially those effects linked to lost-time injuries. The aim of this paper was to evaluate predictors of workplace lost-time injuries and how they may be related to obesity or high body mass index by examining factors associated with lost-time injuries in the health care sector, a well-studied industry with the highest number of reported time loss injuries in Canada. A literature review focusing on lost-time injuries in Registered Nurses (RNs) was conducted using the keywords and terms: lost time injury, workers' compensation, occupational injury, workplace injury, injury, injuries, work, workplace, occupational, nurse, registered nurse, RN, health care, predictors, risk factors, risk, risks, cause, causes, obese, obesity, and body mass index. Data on predictors or factors associated with lost-time injuries in RNs were gathered and organized using Loisel's Work Disability Prevention Management Model and extrapolated upon using existing literature surrounding obesity in the Canadian workplace.

Computer Adaptive Testing Method for Measuring Disability in Patients With Back Pain

  • Choi, Bongsam
    • 한국전문물리치료학회지
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    • 제19권3호
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    • pp.124-131
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    • 2012
  • Most conventional instruments measuring disability rely on total score by simply adding individual item responses, which is dependent on the items chosen to represent the underlying construct (test-dependent) and a test statistic, such as coefficient alpha for the estimate of reliability, varying from sample to sample (sample-dependent). By contrast, item response theory (IRT) method focuses on the psychometric properties of the test items instead of the instrument as a whole. By estimating probability that a respondent will select a particular rating for an item, item difficulty and person ability (or disability) can be placed on same linear continuum. These estimates are invariant regardless of the item used (test-free measurement) and the ability of sample applied (sample-free measurement). These advantages of IRT allow the creation of invariantly calibrated large item banks that precisely discriminate the disability levels of individuals. Computer adaptive testing (CAT) method often requiring a testing algorithm promise a means for administering items in a way that is both efficient and precise. This method permits selectively administering items that are closely matched to the ability level of individuals (measurement precision) and measuring the ability without the loss of precision provided by the full item bank (measurement efficiency). These measurement properties can reasonably be achieved using IRT and CAT method. This article aims to investigate comprehensive overview of the existing disability instrument for back pain and to inform physical therapists of an alternative innovative way overcoming the shortcomings of conventional disability instruments. An understanding of IRT and CAT method will equip physical therapist with skills in interpreting the measurement properties of disability instruments developed using the methods.

라쉬분석을 이용한 세 가지 요통 장애 설문지의 비교 (A Comparison of Three Low Back Disability Questionnaires With Rasch Analysis)

  • 김경모;박소연;이충휘
    • 한국전문물리치료학회지
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    • 제18권3호
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    • pp.94-102
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    • 2011
  • The purpose of this study was to review existing assessment tools for patients with low back pain and improve them through combination. A total of 314 patients with low back pain participated. Their condition was assessed using the Oswestry Disability Questionnaire (ODQ), the Quebec Back Pain Disability Scale (QBPD), and the Back Pain Functional Scale (BPFS). Rasch analysis was applied to identify inappropriate items, item difficulties, and the separation index. In this study, the 'sex life' item of the ODQ (10 items) and the 'sleeping' item of the BPFS (12 items) showed misfit statistics, whereas all items of the QBPD (20 items) were appropriate. After combining the ODQ, QBPD and BPFS, Rasch analysis was applied. The 'pain intensity', and the 'sex life' item of the ODQ and the 'throw a ball' item of QBPD showed misfit statistics. These 3 items were retained for further analysis. The remaining 42 combined ODQ-QBPD-BPFS items were arranged according to difficulty. For all subjects, the most difficult item was 'pain intensity', whereas the easiest was 'take food out of the refrigerator'. As the separation index of 42 combined ODQ-QBPD-BPFS was higher than that of the three questionnaires separately, difficulty of items varied with some need for rearrangement. The results of this study confirmed the possibility and need for a new back pain disability assessment tool, and produced one. Further study is needed to refine the questionnaire in consideration of psychosocial and occupational factors.

씹기근육 수축을 동반한 머리목굽힘운동이 목통증 환자의 깊은목뼈굽힘근의 수축두께와 목장애지수에 미치는 영향 (Effect of Craniocervical Flexion Exercise with Masticatory Muscle Contraction on Deep Cervical Muscle Thickness and Neck Disability Index in Patient with Neck Pain)

  • 박은수;최호석;신원섭
    • 대한물리의학회지
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    • 제11권4호
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    • pp.139-146
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    • 2016
  • PURPOSE: The purpose of this study was to determine the effect of craniocervical flexion exercise with masticatory muscle contraction in patients with neck pain. Patients with neck pain also experience muscle weakness and limitation of activities of daily living. Craniocervical flexion exercise with masticatory muscle contraction may increase the thickness of the deep cervical flexor muscles, thereby reducing pain and limitations on activities of daily living. METHODS: Twenty-six volunteers participated in this study. The subjects were randomly divided into an experimental group (n=13) and a control group (n=13). Both groups performed craniocervical flexion exercise using a pressure biofeedback unit; the experimental group performed craniocervical flexion exercise with masticatory muscle contraction for 20 minutes, 3 times a week for 4 weeks. Assessment tools included ultrasonography for measurement of muscle thickness and the Neck Disability Index for the level of pain and function. RESULTS: The rate of change in muscle thickness in both groups significantly increased (p<.05), with a significantly greater increase in the experimental group than in the control group (p<.05). The Neck Disability Index score significantly improved (p<.05) in both groups, with significantly greater improvement in the experimental group compared with the control group (p<.05). CONCLUSION: These results suggest that craniocervical flexion exercise with masticatory muscle contraction can be effective in increasing muscle thickness and improving the Neck Disability Index score in patients with neck pain.