• 제목/요약/키워드: Disability and Health

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사무직 근로자의 허리통증 및 기능 개선에 대한 3가지 중재의 효과 비교 (Comparison of the Effects of Three Interventions on Back Pain and Functional Improvement in Office Workers)

  • 허준;장우정;김명철
    • 대한통합의학회지
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    • 제10권3호
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    • pp.221-232
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    • 2022
  • Purpose : In this study, rectus abdominis relaxation intervention was administered to office workers who were experiencing low back pain due to sitting for extended periods of time in an incorrect posture. This study aimed to develop an effective treatment program for individuals who experience low back pain. This was done by verifying changes using the Korean Oswestry Disability Index (K-ODI) and considering kyphosis. Both factors are related to low back pain. Methods : This study included 39 office workers with low back pain. The participants were randomly assigned to three groups. 1) The functional massage and self-stretching (FAS) group (n=14). 2) The diaphragmatic breathing and self-stretching (DAS) group (n=13). 3) The self-stretching (S) group (n=12). All groups applied the intervention for 30 minutes a day, thrice a week for four weeks. All participants were evaluated using the K-ODI and thoracic kyphosis measurements before and after the intervention. Results : The findings of this study are as follows. All three groups had improved K-ODI scores after the intervention. The FAS and DAS groups showed a greater effect than the S group. However, there was no difference in effect between the FAS and DAS groups. Kyphosis was not improved in any of groups after the intervention, and there was no difference between the three groups. Conclusion : This study showed that the FAS, DAS, and S programs were effective relaxation interventions that improved the K-ODI for office workers with low back pain. The FAS and DAS programs were more effective than the S program. Therefore, it is recommended to combine relaxation and stretching of the rectus abdominis muscle for office workers who experience low back pain. Clinically, a relaxation intervention that is most appropriate for the patient, depending on his or her condition, should be.

저항성 운동과 그룹 운동을 병합한 프로그램이 뇌성마비 아동의 균형능력, 파악력 및 삶의 질에 미치는 영향 (The Effect of a Program Combining Resistance Exercise and Group Exercise on Balance, Grip Strength, and Quality of Life of Children with Cerebral Palsy)

  • 김성현;신호진;함석찬;박선욱;조휘영;이민구
    • 대한물리의학회지
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    • 제15권4호
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    • pp.75-85
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    • 2020
  • PURPOSE: Cerebral palsy is a common cause of disability in children, requiring constant rehabilitation. Improving balance in children with cerebral palsy helps to alleviate daily movement and the quality of life. This study examines a program that combines Resistance Exercise and Group Exercise, and investigates the effect on trunk control ability, balance ability, maximum grip strength, and quality of life of children with cerebral palsy. METHODS: Totally, 9 children with cerebral palsy participated in this study. Resistance exercise was performed for 8 weeks, 40 minutes every day. Group Exercise was conducted for 8 weeks, 40 minutes each Sunday. All participants were evaluated by the Korean version of the trunk control measurement scale, pediatric reach test, grip strength test, and KIDSCREEN-52. RESULTS: The trunk control ability was significantly improved in all subcategories (p < .05). In the pediatric reach test, the left and right directions were significantly improved (p < .05). Maximum grip strength was significantly improved in both hands (p < .05). The quality of life significantly improved in total score, physical well-being, general moods, self-perception, autonomy, relationship with parents, and home life (p < .05). CONCLUSION: Considering the encouraging results, we propose to use Resistance Exercise and Group Exercise as programs other than rehabilitation treatment in hospitals, to improve motor function and quality of life of children with cerebral palsy.

ICF Tool을 적용한 뇌졸중 환자의 바닥에 앉고 일어서기에 대한 중재전략의 증례 (A Case Report of Intervention Strategy applied ICF Tool about Floor to Stand and Stand to Floor for Stroke Patient)

  • 윤태원;김태윤
    • 대한물리치료과학회지
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    • 제18권1호
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    • pp.33-49
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    • 2011
  • The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.

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COVID-19과 한국의 사회적경제: 성과와 미래 과제 (COVID-19 and Social Enterprise in Korea: Achievements and Future Directions)

  • 조영복
    • 디지털융복합연구
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    • 제20권3호
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    • pp.265-273
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    • 2022
  • 본 연구는 COVID-19 팬데믹 하에서 사회적경제기업의 상황을 살펴보고 미래과제를 제시하는데 있다. 2019년말 시작된 COVID-19 팬데믹이 현재까지 건강, 경제, 사회, 네트워킹 등 우리 사회의 다양한 영역에 영향을 미치고 삶을 황폐하게 하고 있다. 바이러스가 호흡기를 통해 전염되는 것으로, 사람 중심의 사회적경제에 장애요인으로서 작용될 것이며, 주요하게는 재정적인 부분에서 기업가들의 활동을 규제하는 모양새로 나타나고 있다. 다만, 팬데믹이 지속되는 과정 속에서도 사회적경제의 규모는 확대되었으며, 청소위생 및 보건업을 중심으로 경제적인 성과와 함께 지역사회 속에서 사회적 성과를 달성하고 있다는 것에서 호혜와 협력에 기반한 사회적경제기업의 협업을 통해 COVID-19 이라는 문제를 해결하고 있다는 것을 확인할 수 있다. 사회적경제의 건강한 생태계 조성을 위해서는 COVID-19에 일차원적으로 대응하기 보다는 경제사회적 안전망 구축차원에서 사회적경제의 지속가능성을 담보할 수 있는 보편적이고 구체적인 미래 과제를 선정, 추진해야 할 것이다.

허리 불안정성이 있는 만성 허리통증 환자의 중간볼기근 약화 유무에 따른 허리 안정화 운동의 효과 비교 (Comparison of the Effects of Lumbar Stabilization Exercise According to the Presence or Absence of Gluteus Medius Muscle Weakness in Chronic Lower Back Pain Patients with Lumbar Instability)

  • 김대호;김선엽
    • 대한물리의학회지
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    • 제19권2호
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    • pp.29-45
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    • 2024
  • PURPOSE: This study aimed to compare the effects of pain level, lower back pain dysfunction level, psychosocial level, hip abductor strength (HAS), number of positive lumbar instability tests, and dynamic balance (DB) by applying lumbar stabilization exercises according to the presence or absence of gluteus medius muscle weakness in chronic lower back pain (CLBP) patients with lumbar instability. METHODS: Thirty-five CLBP patients with lumbar instability were divided into the gluteus medius weakness (n = 18) and gluteus medius non-weakened (n = 17) groups using the gluteus medius manual muscle test. Intervention applied conservative physical therapy and lumbar stabilization exercises to both groups that lasted three times a week for four weeks. To compare the intervention effects, the quadruple visual analog scale (QVAS), the Korean version of the Oswestry disability index (K-ODI), fear-avoidance beliefs questionnaire (FABQ), HAS, lumbar instability tests positive response counter (LIC), and DB were measured. RESULTS: Significant differences were shown for QVAS, K-ODI, FABQ, HAS, LIC, and DB for both groups pre- and post-intervention (p < .05). Compared to the gluteus medius weakness group, the gluteus medius non-weakened group showed a significant difference (p < .05) in the changes in QVAS, K-ODI, FABQ-W, FABQ-total, and HAS. CONCLUSION: In CLBP patients with lumbar instability, having gluteus medius weakness was less effective in improving lumbar stabilization exercise than gluteus medius non-weakness regarding pain level, lower back pain dysfunction level, psychosocial level excluding physical activity, and hip abductor strength. Therefore, additional gluteus medius strengthening exercises are necessary for patients with lumbar instability and gluteus medius muscle weakness.

3차원 요부안정화 운동이 20대 요통환자의 통증과 동적 및 정적 균형능력 향상에 미치는 효과 (The Effects of 3-Dimensional Lumbar Stabilization Exercise have an effect on the improvement of pain and static or dynamic balance ability in 20's age group with Low Back Pain)

  • 김규용;안창식;김성수
    • 대한물리의학회지
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    • 제6권2호
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    • pp.235-246
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    • 2011
  • Purpose: The aim of this study is to compare and assess the effects of lumbar stabilization exercise on the balance ability of young college studets with low back pain after having performed spinal stabilization exercise by using 3-dimensional air-balance system and gym ball. Methods: The subjects of this study were 34 low back patients in their early twenties. They were divided into two groups: 3-dimensional lumbar stabilization exercise group(N=17) and gym ball lumbar stabilization exercise group(N=17). The period of the intervention was for five weeks. VAS(Visual Analogue Scale) for pain test, ODI(Oswestry Disability Index) for ADL limitation test, Tetrax system for static balance test, and Air-balance system 3D for dynamic balance test were used as evaluation tools for this study. Results: Pain showed significant decrease in both groups after having performed the experiment, but ADL limitation of the groups did not show any remarkable difference between before and after the experiment. Dynamic balance ability in the 8-directional angle comparison test significantly increased in all directions except for the backward, left-backward, and right-backward directions. As for dynamic balance ability in the 8-directional postural test, 3D exercise group showed statistically significant reduction in every direction while gym ball exercise group did not(p<.05). However, when it comes to static balance ability in the weight distribution and stability test, there was not significantly change between pre and post test in both groups. Conclusion: This study shows 3-dimensional lumbar stabilization exercise is more effective in the lumbar stabilization of coordinated movement than gym ball exercise, which may imply that 3D air-balance system can be used for the therapeutic treatment of body imbalance for patients with low back pain.

목뼈 부위 감각운동 조절 훈련이 만성 목 통증 환자의 통증과 기능, 심리사회적 수준에 미치는 영향 (Effects of Cervical Sensorimotor Control Training on Pain, Function and Psychosocial Status in Patients With Chronic Neck Pain)

  • 민인기;김선엽
    • 한국전문물리치료학회지
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    • 제28권1호
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    • pp.36-46
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    • 2021
  • Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.

국내 만성질환 노인환자의 한의과 진료서비스 이용과 사망률 및 파킨슨병 발생률의 관계연구 (The Relation of Korean Medicine Services Use on the All-cause Mortality and Incidence of Parkinson's disease and Elderly Patients with Chronic Disease in Korea)

  • 우연주
    • 대한예방한의학회지
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    • 제25권3호
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    • pp.25-37
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    • 2021
  • Objectives : To investigate the effectiveness of Korean Medicine services use on the all-cause mortality and incidence of Parkinson's disease(PD) in elderly patients with chronic disease based on the National Health Insurance Service Corhort Database (elderly), called as the NHIS-senior. Methods : This study was a retrospective cohort analysis conducted using the NHIS-senior. Patients with chronic diseases over 65 years old who were not diagnosed PD during 2007-2009 were identified. The case group was defined as patients who used both Korean Medicine and Western Medicine services and the control group consisted of patients who used Western Medicine service only. The all-cause mortality and incidence of PD was analyzed using the Cox proportional hazard model after a propensity score matching(PSM) with a 1:1 ratio. Results : After PSM, the cohort included 47,546 subjects (23,773 in the case group, 23,773 in the control group). Sex, age, comorbidity, severity of disability, and neurology medical service utilization were adjusted in both groups. The mortality was 0.668 times (95% C.I.: 0.646-0.690) lower in the case group than the control group, which was statistically significant (p<0.001). The incidence of PD was 1.051 times (95% C.I.: 0.962-1.148) higher in the case group than the control group, which was not statistically significant(p=0.272). Conclusion : It was not obvious that the use of both Korean Medicine service and Western Medicine services for prevention of PD is benefitial than using only Western Medicine. But it would be possible that using both Korean Medicine and Western Medicine services decreases the mortality than using Western Medicine alone.

우리나라 직장인 피로의 역학적 특성 (Correlates of Self-rated Fatigue in Korean Employees)

  • 장세진;강명근;현숙정;차봉석;박종구;박준호;김성아;강동묵;장성실;이경재;하은희;하미나;고상백
    • Journal of Preventive Medicine and Public Health
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    • 제38권1호
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    • pp.71-81
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    • 2005
  • Objective : To elucidate the correlates of self-rated fatigue in Korean employees. Methods : The data for 10,176 (men, 7,984; women, 2,192; mean age, 34.2; SD: 8.8) employees recruited from a nationwide sample were examined. A structured questionnaire was used to measure the participants' fatigue, sociodemographics (sex, age, education, and marital status), job-related characteristics (work duration, grade at work, work hours, shiftwork, employment type, and magnitude of workplace), and health-related habits (smoking, drinking, coffee intake, and exercise). Two types of measurement for fatigue were used to evaluate the magnitude of fatigue: self-rated question and a standardized measurement tool (Multidimensional Fatigue Scale: MFS). Results : According to the self-rated fatigue, 32% of employees reported that they felt fatigue for the past two weeks, and 9.6% of males and 8.7% of females had experienced excessive fatigue (6 months or more). Hierarchical multiple regression analysis showed that fatigue measured by MFS was more common in women, younger, college or more graduated, single, and employees who do not regularly exercise. Fatigue was also associated with long work hours, and the size of the workplace (<1,000 employees). Conclusions : These results suggest that fatigue has been considered as a common complaint, and that it is affected by job-related factors like work hours and the workplace size as well as sociodemographics or health-related behaviors. Further research is needed to clarify the effects of fatigue on adverse health outcomes, work performance, work disability, sick absence and medical utilization, and to examine the relationship of job characteristics (e.g.: work demand, decision latitude) to fatigue.

A Comparative Study of Item Difficulty Hierarchy of Self-Reported Activity Measure Versus Metabolic Equivalent of Tasks

  • Choi, Bong-Sam
    • 한국전문물리치료학회지
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    • 제20권3호
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    • pp.89-99
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    • 2013
  • The purposes of this study were: 1) to show the item difficulty hierarchy of walking/moving construct of the International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM), 2) to evaluate the item-level psychometrics for model fit, 3) to describe the relevant physical activity defined by level of activity intensity expressed as Metabolic Equivalent of Tasks (MET), and 4) to explore what extent the empirical activity hierarchy of the ICF-AM is linked to the conceptual model based on the level of energy expenditure described as MET. One hundred and eight participants with lower extremity impairments were examined for the present study. A newly created activity measure, the ICF-AM using an item response theory (IRT) model and computer adaptive testing (CAT) method, has a construct on walking/moving construct. Based on the ICF category of walking and moving, the instrument comprised items corresponding to: walking short distances, walking long distances, walking on different surfaces, walking around objects, climbing, and running. The item difficulty hierarchy was created using Winstep software for 20 items. The Rasch analyses (1-parameter IRT model) were performed on participants with lower extremity injuries who completed the paper and pencil version of walking/moving construct of the ICF-AM. The classification of physical activity can also be performed by the use of METs that is often preferred to determine the level of physical activity. The empirical item hierarchy of walking, climbing, running activities of the ICF-AM instrument was similar to the conceptual activity hierarchy based on the METs. The empirically derived item difficulty hierarchy of the ICF-AM may be useful in developing MET-based activity measure questionnaires. In addition to convenience of applying items to questionnaires, implications of the finding could lead to the use of CAT method without sacrificing the objectivity of physiologic measures.