• Perspectives in Nursing Science
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• 제2권1호
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• pp.76-91
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• 2005

Stroke patients often develop post stroke sequelae when they survive. Post stroke fatigue and emotional disturbances including depression are common along with motor dysfunction. However, medical personnel have paid relatively little attention to emotional changes and the presence of fatigue following strokes. Post-stroke fatigue was common, occurring in 57% of the patients in our series. The post-stroke fatigue appears to be related to the pre-stroke fatigue, physical disability and post stroke depression (PSD) although the relation to the lesion location remains elusive. The prevalence of post-stroke emotional disturbance has been reported to range from 12% to 64%. The wide variation in the frequency of post stroke depression may be related to methodological heterogeneity in items such as the criteria for depression, the timing of assessment, and the study population. Emotional incontinence, which is characterized by inappropriate or excessive laughing or crying is also common. The incidence of and factor related to this post-stroke emotional incontinence (PSEI) also remains unclear. We reported that out-patients with single, unilateral stroke, 18% had PSD and 34% had PSEI. Although both PSD and PSEI were related to motor dysfunction and location (anterior vs. posterior cortex) of the lesion, the latter was a stronger determinant for PSD. PSEI was more closely associated with subcortical strokes than was PSD. Another manifestation of post stroke patients is the occurrence of post stroke anger proneness (PSAP). They may become easily irritated, impulsive, less generous, and prone to be angry or aggressive at others. We also have reported the PSAP which seems to be closely associated with the presence of PSEI. The lesion distribution appears to be also similar. Both PSEI and PSAP respond well to serotonin reuptake inhibitors suggesting that these symptomsmay be possibly related to the alteration of serotonin after brain injury. Likewise, PSAP also produces a great deal of frustration and embarrassment among patients and caregivers. In summary, emotional disturbances such as depression, emotional incontinence, anger-proneness and fatigue are fairly common but under-recognized sequelae of stroke. These emotional disturbances decrease the quality of life of the patients and caregivers, and may adversely affect the overall prognosis. Therefore, these problems must be appropriately recognized and alleviated. Finding strategies to relieve the symptoms is imperative by understanding the causative factors in individual patient.

• 한국환경보건학회지
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• 제37권4호
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• pp.250-257
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• 2011

Objectives: This study was aimed at re-assessing the environmental burden of disease attributable to waterrelated diseases using available local data from Korea. Methods: The general methods and the operational definitions for water, sanitation and hygiene applied to the study were based on an environmental burden of disease study conducted by WHO. Eleven water-related diseases were selected. The attributable fraction for diarrhea was calculated by assessing local exposure levels to drinking water, sanitation and hygiene according the scenario-based approach. The attributable fractions for the other ten diseases were derived from the results of the environmental burden of diseases study. The attributable DALYs were measured by using the attributable fractions and local health statistics. Results: The total environmental burden of disease attributable to water, sanitation and hygiene for Korea was 0.9210 DALY per 1000 capitals. Of the total burden of disease, the attributable burden of diarrhea was 0.8863 (96.1%), the attributable burden of malaria and malnutrition was 0.0236 and 0.0063 DALY per 1000 capitals, respectively. There was little burden of disease measured for other diseases. Conclusions: This study is meaningful in re-assessing the environmental burden of disease using available local exposure data and health statistics. Quantitative analysis of the environmental risk factors and a health impact assessment would be helpful to prioritize health policies or interventions in the future.

• Journal of Oral Medicine and Pain
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• 제40권2호
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• pp.63-71
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• 2015

Purpose: To investigate the relationship between headache and sleep by evaluating sleep quality, daytime sleepiness, and specific features related to sleep-disordered breathing (SDB). Methods: One hundred one subjects with headache and 118 healthy controls were enrolled. To collect various information on headache attacks, headache group completed self-reported questionnaire about the characteristics of headache attacks and the migraine disability assessment (MIDAS) questionnaire. The subjective quality of sleep was evaluated in all of the subjects using the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). In addition, the following specific features of sleep were evaluated in 28 subjects selected randomly from each group: apnea-hypopnea index (AHI), prevalence of SDB, nocturnal oxygen saturation (SaO2), and oxygen desaturation index (ODI) as measured using a portable monitoring device. Results: The global PSQI and the prevalence of poor sleeping (global PSQI >5), ESS scores and the prevalence of daytime sleepiness (ESS score >10) were significantly higher in the headache group (both p<0.0001, respectively). The mean scores on the numerical rating scale and the MIDAS were significantly higher in the poor-sleeper group than in the good-sleeper group (p=0.0347 and p=0.0016, respectively). The global PQSI and prevalence of daytime sleepiness were significantly higher in the chronic-headache group than in the acute-headache group (p=0.0003 and p=0.0312, respectively). Conclusions: There is a significant association between headache and sleep. Especially, severity and chronicity of headache were significantly associated with sleep quality and daytime sleepiness.

• 척추신경추나의학회지
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• 제8권1호
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• pp.1-13
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• 2013

Objectives: The present study examines the domestic trend of Chuna manual therapy on cervical spinal disorders in Korea. Methods: We investigated the studies on Chuna manual therapy for cervical spinal disorders via searching 6 Korean web databases. As a result, 51 research papers were found to be analyzed according to their published year, published institution, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of cervical spinal disorders and ethical approvals. Results: The number of the research papers published tended to increase every year. The studies on Chuna manual therapy for cervical spinal disorders were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Chuna spine manipulation therapy - cervical spine technique. Visual analogue scale (VAS), neck disability index(NDI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusions: Reviewing the domestic trend of studies on Chuna manual therapy for cervical spinal disorders and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

• 대한물리의학회지
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• 제2권2호
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• pp.195-203
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• 2007

Purpose : The purpose of this study was to evaluate the effects of local vibration on knee joints on ability of postural control. Methods : The subjects(50) were divided into control group(25) and vibration group(25). Vibration group was given vibration on knee joint for 10 minutes and control group was given resting for 10 minutes. All subjects of each group were tested on MFT balance tester board for 30 seconds and MFT Balance Test English 1.7 was used to measure ability of postural control pre and post test. Results : 1. Laterality didn't have statistically significant difference pre and post test in both groups(p<0.05). 2. In the control group Body stability didn't have significant difference pre and post test(p>0.05), but had significant difference in the vibration group(p<0.05). 3. At assessment Movement of COG, sector2 in the control group and sector 1, 5 in the experimental group had significant difference pre and post test(p<0.05). Conclusion : From this result vibration on knee have an effect on Body stability. Therefore, the vibration will be effective in treatment of patients who have disability of postural control.

• The Korean Journal of Pain
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• 제28권1호
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• pp.11-21
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• 2015

Background: Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. Methods: This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 patients with lumbar disc herniation. There were 120 patients per trial either receiving local anesthetic alone (60 patients) or local anesthetic with steroids (60 patients). Results: Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing chronic pain and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of steroids compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for pain relief in the steroid group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of patients. The proportion of patients nonresponsive to initial injections was also lower in the group for local anesthetic with steroid in the interlaminar trial. Conclusions: The results of this assessment show significant improvement in patients suffering from chronic lumbar disc herniation with 3 lumbar epidural approaches with local anesthetic alone, or using steroids with long-term follow-up of up to 2 years, in a contemporary interventional pain management setting.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.19-29
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• 2017

Background: Patients after rotator cuff (RC) surgery experienced pain, weakness and limited of motion of the shoulder. Physical therapists have used heat therapy, electrotherapy, range of motion (ROM) exercise and other methods to treat patients after RC surgery. In addition, functional taping is also used to support joint movement and to increase shoulder joint stability. Objects: The purpose of this study was to determine the initial effects of functional taping using non-elastic tape on pain, strength and ROM of the shoulder following RC surgery. Methods: Forty-eight patients with who underwent RC surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, $n_1=25$) and a control group (CG, $n_2=23$). First, non-allergic tape was applied to the shoulder to prevent skin irritation. The EG applied functional taping using non-elastic tape and the CG applied sham taping using elastic tape. Assessment tools included the shoulder pain and disability index for functional activity score, visual analog scale for level of pain, shoulder muscle strength, hand grip strength and ROM testing. Results: Pain score in the both group significantly decreased (p<.05), and change in pain score of in the EG increased significantly than in the CG (p<.05). Shoulder strength and ROM in the both group significantly increased (p<.05). Especially external rotation and extension of the shoulder ROM in the EG increased significantly more than in the CG (p<.05), but the rate of change in the two groups showed no significant difference. Conclusion: These results suggest that functional taping using non-elastic tape was initially effective in decreasing pain score level in patients with RC surgery.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.56-66
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• 2014

For maintaining adequate psychometric properties when reducing the number of items from an instrument, item level psychometrics is crucial. Strategies such as low item correlation or factor loadings, using classical test theory, have traditionally been advocated. The purpose of this study is to describe the development of a new short form assessing the impact of low back pain on physical activity. Rasch measurement model has been applied to the International Classification of Functioning, Disability and Health Activity Measure (ICF-AM). One hundred and one individuals with low back pain aged 19-89 years (mean age: $48.1{\pm}17.3$) who live in the community were participated in the study. Twenty-seven items of lifting/carrying construct of the ICF-AM were analyzed. Ten items were selected from the construct to create a short form. Item elimination criteria include: 1) high or low mean square (out of the range: .6-1.4 for the fit statistics), 2) similar item calibrations to adjacent items, 3) person separation value, and item-person map for potential gap in person ability continuum. All 10 items of the short form fit to the Rasch model except one item (i.e., carrying toddler on back). Despite its high infit and outfit statistics (1.90/2.17), the item had to be reinstated due to potential gaps at the upper extreme of person ability level. The short form had a slightly better spread of person ability continuum compared to the entire set of item. The created short form separated individuals with low back pain into nearly 4 groups, while the entire set of items separated the individuals into 6 groups. The findings prompted multidimensional models for better explanation of the lifting/carrying domain. The item level psychometrics based on the Rasch model can be useful in developing short forms with rationally retained items.

• 척추신경추나의학회지
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• 제8권2호
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• pp.31-38
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• 2013

Objectives : The present study examines the domestic trend of Chuna treatments on lumbar spinal disorder in Korea. Methods : We investigated the studies on Chuna treatments for lumbar spinal disorder via searching 10 Korean web databases. As a result, 63 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of lumbar spinal disorder and ethical approvals. Results : The number of the research papers published tends to increase every year. The studies on Chuna treatments were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Cox flexion & distraction technique. Visual analogue scale(VAS), oswestry disability questionnaire(ODI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusion : Reviewing the domestic trend of studies on Chuna treatments for lumbar spinal disorder and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

• 치위생과학회지
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• 제20권1호
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• pp.16-24
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• 2020

Background: Dental treatment has shifted to the center of the community, and the public policy of the country has expanded to support the vulnerable classes such as the disabled. The dental profession needs education regarding oral health services for persons with disabilities, and it is necessary to derive the competencies for this. Therefore, we conducted this study to derive the normative ability to understand the role of a dental hygienist in the oral health service for persons with disabilities and improvement plans for education. Methods: We conducted a qualitative analysis for deriving competencies by analyzing the data collected through in-depth interviews with experts in order to obtain abilities through practical experience. Based on the competency criterion, relevant competency in the interview response was derived using the priori method, and it was confirmed whether the derived ability matched the ability determined by the respondent. Results: The professional conduct competencies of dental hygienists, devised by the Korean Association of Dental Hygiene, consists of professional behavior, ethical decision-making, self-assessment skills, lifelong learning, and accumulated evidence. Also, core competencies of the American Dental Education Association competencies for dental hygienist classification such as ethics, responsibility for professional actions, and critical thinking skills were used as the criterion. The dental hygienist's abilities needed for oral health care for people with disabilities, especially in the detailed abilities to fulfill these social needs, were clarified. Conclusion: To activate oral health care for people with disabilities, it is necessary for dental hygienists to fulfill their appropriate roles, and for this purpose, competency-based curriculum restructuring is indispensable. A social safety net for improving the oral health of people with disabilities can be secured by improving the required skills-based education system of dental hygienists and strengthening the related infrastructure.