• Title/Summary/Keyword: Elderly rehabilitation

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Roles of Primary Health Practitioner and Activities to Increase the Job Performance (보건진료원 업무현황 및 업무향상활동)

  • Ko, Il-Sun;Lee, Kyung-Ja;Cho, Won-Jung;Kim, Jin-Soon;Song, Eun-Kyung;Lee, Tae-Wha
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.4
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    • pp.361-369
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    • 2005
  • Purpose: The purpose of the study was to analyze the present status of community health practitioner activities and efforts to improve the job performance. Method: This study employed descriptive exploratory design. The sample consisted of 1,892 community health practitioners which was 90 % of population of community health practitioners. The data was analyzed by using SPSS Windows 10.0. Result: The most popular activities of community health practitioners were women's health, chronic degenerative disease management, elderly health, and outpatient care of primary health care. The activities that community health practitioners want to strengthen were outpatient care, disease prevention, rehabilitation, health promotion, and counseling. The efforts to improve the job performance were consult to other health care professionals, discussion with patient and families to choose effective treatment options. Community health practitioners knew that they were exposed to malpractice and hould try to make many efforts to improve their performance. Conclusion: The roles and activities of community health practitioners should be changed to the shift of health care environment and systems.

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The Efficacy of Community-Based Rehabilitation Exercise to Improve Physical Function in Old Women with Knee Arthritis (지역사회중심재활운동이 여성 슬관절염 환자의 신체기능에 미치는 효과)

  • Kim, Su-Min;Song, Ju-Min
    • The Journal of Korean Physical Therapy
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    • v.22 no.1
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    • pp.9-17
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    • 2010
  • Purpose: The purpose of this study was to compare the effects of Tai-Chi exercise (TCE) and resistance exercise (RE) when used as part of a community-based exercise program on improvement of physical function in elderly women with knee arthritis. Methods: Forty-seven women with knee arthritis participated in this study. They were assigned to one of two groups: the TCE group (n=22) or the RE group (n=25). Tai-Chi exercise and resistance exercise sessions were held for 1 hour per session, twice per week, for 8 consecutive weeks. At pre-treatment and post-treatment, subjects were tested using the following measurements: one-legged stand test (sec), a functional reach test (cm), a test of the strength of the knee extensor and flexor muscles, determination of the pathway of center of foot pressure and vertical ground reaction force for stance phase at pre and post treatment time points. An independent t-test and a ${\chi}^2$ were used to determine the significance of differences between group means using SPSS 12.0. Results: After 8 weeks of participation in the exercise programs, there were significant improvements for both groups in joint pain, difficulty of performing activity, muscle strength of knee extensor and flexor. Also, vertical ground reaction force increased at the loading response phase for both groups. The RE group was significantly different from TC group on the eyes-closed one-legged stand test (sec). Conclusion: Tai-Chi exercise and resistance exercise programs improve physical functioning and reduce pain and locomotion difficulties.

The Effect of Disturbed Vision on Gait Parameters of the Young Healthy Population (혼란스러운 시각의 영향에 따른 보행요소들의 평가)

  • Kim Kyoung;Park Young-Han;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.12 no.1
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    • pp.41-47
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    • 2000
  • BACKGROUND AND PURPOSE. The purpose of this study is to investigate the effect of the disturbed vision on the gait distance parameters on the healthy young population. SUBJECTS. Twenty four healthy college aged individuals are randomly assigned to both a condition with a strobe light and the other condition without a strobe light. METHODS. The instrumentation used for gait analysis is the GaitRite electronic walkway system with a personal IBM computer. The examiner naked all the subjects to walk 6 times on the gait mat without the strobe light and. 6 times on the mat with the strobe light. The first 4 trials were practice and the last two trials were recorded in both conditions. The gait parameters analyzed were as follows : velocity, cadence, step length, and heel to heel base of support. RESULTS. Paired samples t-test used for this study did not found any significant differences between the two conditions because the p-values that were analyzed on the experiment were Utter than 0.05. The gait parameters that were analyzed included cadence, velocity, left and right heel to heel base of support, and left and right step length. DISCUSSION AND CONCLUSION. Based on this population, the condition of disturbed vision via the effect of the strobe light was not significantly challenging to compromise the body's sensory systems. However, in the elderly population, these systems can undergo age related changes. Visual changes rapidly decline in people 60 to 80 years of age and changes in the vestibular system include $20-40\%$ reduction in hair cells.

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A Study on the Budget Allocation to Public Health Programs Using Matrix Delphi Technique (매트릭스 구성 델파이법을 이용한 공공보건사업 예산배분 연구)

  • 장원기;정경래
    • Health Policy and Management
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    • v.10 no.4
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    • pp.99-115
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    • 2000
  • This study was conducted to get a resonable set of budget allocation to public health programs. Matrix Delphi technique was used to obtain the logic of study results and eventually to form a human model which could predict opinion of professionals on budget allocation. Thirty-two professionals in academic and governmental area responded to Delphi survey. Questionnaire was developed using matrix formation, and the matrix was formed by 6 decision criteria on budget allocation and 26 public health programs. The decision criteria are as following: size of problem(morbidity), severity of problem, social equity, importance of prevention, technical feasibility and efficiency of programs. Severity of problem dropped out of the model because it had significant correlation with the size of problem. A total score of each program was obtained by weighting the relative importance of each criteria which also were given by survey respondents. These total scores indicate that the most important public health program is vaccination for infants and children in terms of budget allocation. Monitoring communicable diseases, mental health program, and anti-smoking program are the next. In addition, respondents were asked of the desirable budget size of each program. The result was rearranged by multiple regression model using the scores of each decision criteria. In this process, the current budget size of central government was provided to the respondents, and included in the model. h set of desirable budgets modified using tile model was obtained. Considering the current size of budget, tile results of the model is very different from that of the total score. Managing dementia is ranked the first. Health promotion program for the elderly, rehabilitation of the disabled and monitoring communicable diseases are the next. The need to increase the budget of vaccination for the infants and children was not found as so high. The matrix structure in Delphi survey gave us the precise basis to make optimal decision, and made it possible to develop an opinion predicting model. However the plentifulness and diversity of professional opinions were not fully obtained due to the limited number of decision criteria.

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Conventional Western Medicine and Complementary and Alternative Medicine on Leg Cramps: A Literature Review (하지 근경련에 대한 기존 양방적 치료와 보완대체요법: 문헌조사)

  • Kwon, Chan-Young;Lee, Boram;Cho, Jae-Heung
    • The Journal of Korean Medicine
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    • v.38 no.3
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    • pp.13-29
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    • 2017
  • Objectives: The objective of this review is to investigate the use of conventional Western medicine (WM) and complementary and alternative medicine (CAM) on leg cramps. Leg cramps are the occurrence of muscular spasm in the leg muscles which occur frequently in the elderly and are frequently observed in the clinical field. Methods: Relevant clinical studies were searched from five medical databases including PubMed, KISS, RISS, OASIS, and J-STAGE. Systematic review, clinical studies, and clinical practice guideline were included in this review. Results: In total, 27 clinical studies, 9 systematic review and meta-analysis, and 1 clinical practice guideline met the inclusion criteria. Included studies were classified and analyzed according to the type of intervention. Studies on quinine and magnesium have been most studied in WM and CAM, respectively. Although quinine shows some clinical effects on leg cramps, however, the risk of side effects are suggested. In addition, magnesium failed to improve the clinically significant effects in most studies. Five case reports using Oriental herbal medicine (OHM) were included and OHMs were effective in improving leg cramps without side effects, however, the quality of evidence was low. Clinical studies on other interventions were lacking. Conclusions: The results of this study indicate that there is no definite treatment standard for leg cramps until now, and there are limitations such as low level of evidence and side effects for each treatment. OHM can be an effective alternative to conventional intervention on leg cramps, therefore, related clinical studies are needed.

TELEPHONE PSYCHOTHERAPY WITH ADOLESCENTS (청소년 정신 장애자에 대한 전화 정신 치료의 효용)

  • Lee, Kil-Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.129-137
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    • 1992
  • This article describes several clinical usefullness of the telephone in psychotherapy with adolescents through case analysis by Tolchin, and discussed various management problems and some practical guidelines for therapists planning to utilize telephone psychotherapy with adolescents through literature analysis. In general, most adolescent patients in regular treatment benefit from knowing that the therapist can be reached by phone and that their call will be returned that same day. The therapist's telephone availability helps the young patient to develope a positive working alliance. Telephone psychotherapy had it's first widespread application in crisis intervention and suicide prevention. It's current uses also include enhancement of self-control in cases of self-destructive adolescents, and management of anxious, depressive, or anorexic adolescents. In addition, such widely divergent modalities of treatment as follow up of patients discharged from a psychiatric hospital, alcoholic rehabilitation programs, drug hotlines, sex counselling group therapy for visually impaired elderly, control of separation anxiety in girls, resolution of fear on the mental disorders, and helpful modality to continue psychotherapy without geographic barrier during longer periods of separation with therapist are currently available via telephone. But telephone psychotherapy is generally not suitable for more self-defensive and introverted cases, more dependent chronic callers, silent cases, test callers. the cases of telephone scatologias, the cases of intellectualized discussion, of more dependent cases calling phone in order to get attention from therapist. Telephone psychotherapy for adolescents serves as an important and useful method in the therapeutic armamentarium for this most challenging and rewarding population.

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A Relationship of Care Time with Functional Status and Patients Characteristics among Patients in Long-term Care Hospitals (장기요양환자에서 환자 특징 및 기능상태와 환자돌봄 시간과의 관련성)

  • Yi, Jee-Jeon;Kim, Jeong-In;Yu, Seung-Hm;Yoo, Hyeong-Sik;Yi, Sang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.3
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    • pp.282-291
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    • 2004
  • Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

Evaluation of Plantarflexion Torque of the Ankle-Foot Orthosis Using the Artificial Pneumatic Muscle (인공공압근육 엑츄에이터를 이용한 족관절 보조기의 족저굴곡 토크 평가)

  • Kim, Kyung;Kwon, Tae-Kyu;Kang, Seung-Rok;Piao, Yong-Jun;Jeong, Gu-Young
    • Journal of the Korean Society for Precision Engineering
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    • v.27 no.6
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    • pp.82-89
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    • 2010
  • Ankle-foot orthosis with an artificial pneumatic muscle which is intended for the assistance of plantarfelxion torque was developed. In this study, power pattern of the device in the various pneumatics and the effectiveness of the system were investigated. The pneumatic power was provided by ankle-foot orthosis controlled by user‘s physiological signal, that is, muscular stiffness in soleus muscle. This pneumatic power can assist plantarflexion torque of ankle joint. The subjects performed maximal voluntary isokinetic plantarflexion motion on a biodexdynamometer in different pneumatics, and they completed three conditions: 1) without wearing the orthosis, 2) wearing the orthosis with artificial muscles turned off, 3) wearing the orthosis activated under muscular stiffness control. Through these experiments, we confirmed the effectiveness of the orthosis and muscular stiffness control using the analyzing isokinetic plantarflexion torque. The experimental results showed that isokinetic torques of plantarflexion motion of the ankle joints gradually increased in incremental pneumatic. The effectiveness of the orthosis was -7.26% and the effectiveness of the muscular stiffness control was 17.83% in normalized isokinetic plantarflexion torque. Subjects generated the less isokinetic torques of the ankle joints in wearing the orthosis with artificial muscles turned off, but isokinetic torques were appropriately reinforced in condition of wearing the orthosis activated under muscular stiffness control(17.83%) compared to wearing the orthosis(-7.26%). Therefore, we respect that developed powered orthosis is applied in the elderly that has weak muscular power as the rehabilitation equipment.

The Study of Footwear Preferences and the Wearing Conditions in the Older Women (노인 여성의 신발 선호도와 착용 실태에 대한 연구)

  • Song, Chang-Ho;Lee, Jong-Dae;Kwon, Yoo-Jung;Lee, Jeon-Hyeong;Park, Jin-Hyun;Song, Hyun-Nam;Kim, Kyung
    • Journal of the Korean Society of Physical Medicine
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    • v.4 no.2
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    • pp.63-71
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    • 2009
  • Purpose:The purpose of this study was to investigate how much the type of footwear affects these preference and wearing conditions in older women. Methods:Two hundred eight women aged $60{\sim}87$ years were recruited from the elder's College and welfare center in Daegu. Each subject performed questionnaire surveys. Chi-square($X^{-2}$) test was used to compare the outcome for differences of age, weight, height, heel height and footwear size. SPSS 12.0 program was used in this study. Results:The type of their possessive shoes were casual shoes (24.8%), running shoes (20.1%) and dress shoes (16%) etc. The type of their short-distance outdoor shoes were casual shoes (32.1%), running shoes (31.4%) etc. The type of their long-distance outdoor shoes were platform shoes (40.3%), dress shoes (31%) etc. Conclusion:The heel height of platform shoes had no relation with demographic factors (age, weight, height), but the size of platform shoes had relation with demographic factors such as age and height except for weight(p<0.05).

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Meditation for Alzheimer's Disease: Systematic Review and Meta-Analysis

  • Lee, Go eun;Kim, Sang ho;Jung, In chul;Kang, Hyung won
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.3
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    • pp.237-249
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    • 2019
  • Objectives: Interest in the use of complementary and alternative treatments to treat dementia. Meditation is used to treat various symptoms of physical and psychological diseases. Some studies suggest that meditation might have positive effects on cognitive functions, especially attention, in the elderly. However, how meditation affects Alzheimer's disease (AD) patients remains unclear. In this review, we assessed the effectiveness of practicing meditation in combination with standard care in AD. Methods: We searched the CCRCT, MEDLINE, EMBASE, AMED and CINAHL databases on 30 May 2017. We included randomized controlled trials (RCTs) that used meditation in adult patients diagnosed with AD. We allocated patients to a meditation combined with standard care or a standard care-only group. Results: The two RCTs met the inclusion criteria. A total of 98 patients were included in the meditation with standard care and standard care-only groups in this review. All meditation programs in the included trials were based on practicing mindfulness. The results of our meta-analysis indicatedthat adjunctive mindfulness meditation programs exerted favourable but non-significant effects on cognitive function on the Mini Mental State Examination (MMSE) (MD=4.68, 95% CI -0.11 to 9.46; Z=1.92, p=0.06). Only one study assessed depression, anxiety, quality of life and stress. No adverse events related to meditation were reported in the included studies. Conclusions: Insufficient data iscurrently available to determine the effectiveness of practicing meditation on patients diagnosed with AD. Hence, further RCTs with high methodological quality and larger sample sizes are needed to effectively estimate the effects of meditation on AD.