The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.
Kang Hyun-sook;Kim Won-ock;Kim Jeong-wha;Wang Myoung-ja;Cho Joung-hee
Journal of Korean Academy of Nursing
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v.34
no.7
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pp.1351-1361
/
2004
Purpose: The purpose of this study was to evaluate the effect of an East-West Self-help program for Rehabilitation of post-stroke patients, Method: A quasi-experimental design was used. The subjects were 75 post stroke clients(Exp. group : 38, Cont. group:37), The subjects of the experimental group participated in the Self-help group program of six sessions, twice a week, during 6 weeks. The program consisted of health education of stroke, exercise, oriental nursing interventions, and therapeutic recreation. The obtained data were analyzed by using the repeated measure ANOVA of SPSS. Result: 1) The score of rehabilitation self-efficacy increased significantly in the experimental group as compared to the control group. 2) The score of BADL, IADL, amount of use & quality of movement of the affected U/E, and grip power increased significantly in the experimental group as compared to the control group. 3)The level of blood cholesterol decreased significantly in the experimental group as compared to the control group. Conclusion: Considering these research results, the program is effective in improving functional abilities and self-management ability. Therefore this program could be implemented as a community based self-help group program for post stroke clients.
The purpose of this study was to identify menopausal resilience in middle-aged women. The data were collected from 227 middle-aged women who participated in friendship and religious activities in the Jeonbuk province. The data were collected through self-report questionnaires, which were constructed to Self-efficacy, family support, social support, menopausal adaptation, resilience. Data were analyzed using frequencies, means, $X^2$_Test, pearson's correlation coefficient and multiple regression with SPSS/WIN 23. Regular exercise(${\beta}=-.15$, p<.01), self-efficacy(${\beta}=.29$, p=<.001), social support(${\beta}=.29$, p=<.001), menopausal Adaptation(${\beta}=.17$, p<.01) were influencing factors and these variables showed an explanatory power of 35.3% (F=18.65, p<.001). Therefore, it is suggested that middle-aged women in menopause can plan to overcome the menopausal crisis positively through nursing interventions that include self-efficacy and social support.
Despite of a lot of studies about proprioception tests, there are little study results to investigate the relationship between the functional movement and proprioception level. In this study, we tried to perform quantitative analysis for the effect of ankle joint proprioception level on the one leg standing postural control ability. Nine healthy people volunteered for this study. Force and position aspects of proprioception were evaluated using the electromyography system (EMG) and mobile clinometer application, respectively. The center of pressure (COP) trajectories, measured by a pressure mat sensor, were used for quantitative analysis of balance for each subject. We computed indices and errors of force and position aspects of proprioception from the EMG and ankle angle. Mean velocity of total and anterior-posterior direction (Vm and Vm_ap), root mean squared distance in anterior-posterior direction (RDap), travel length (L), and area (A) of COP trajectories were also calculated as indices of postural control ability of subjects. Two aspects of proprioception showed the low correlation from each other as previous studies. However, the EMG error of gastrocnemius lateral activation showed a high correlation coefficient with COP variables such as Vm (ρ=0.817, p=0.007), Vm_ap (ρ=0.883, p=0.002), RDap (ρ=0.854, p=0.003), L (ρ=0.817, 0.007) and A (ρ=0.700, p=0.036). Within our knowledge, this is almost the first study that investigated the relationship between proprioception level and functional movement. These study results could support that the ankle joint proprioception facilitation exercise would have positive effects on functional balance rehabilitation interventions.
Kim, Won-Gi;Kim, Yong-Seong;Kim, Yong-Beom;Jeong, Ho-Jin;Kim, Jae-Woon;Cho, Woon-Su
The Journal of Korean Physical Therapy
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v.29
no.4
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pp.175-180
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2017
Purpose: This study examined the effects of fast walking training on a treadmill on the spinal alignment and muscle thickness of normal adults. Methods: A total of 36 college students in their twenties participated in the study for eight weeks, and they were divided into the normal walking, fast walking, and speed change groups. All the groups were measured in a pre-test before training. The subjects performed exercise three times per week for six weeks. A post-test was conducted six weeks after training began, and a follow-up test was done two weeks after the training ended.Trunk and pelvic tilts were measured in Formetric 4D for the spinal alignment of the subjects. The muscle thickness was examined in the trunk with an ultrasound test. Repeated-measures ANOVA was conducted to test the main effects and interactions among the measurement variables according to time and group. Results: Significant differences were observed in the pelvic tilt according to time. There were significant differences in the external oblique, internal oblique, transverse abdominal muscle according to time. The post-test results showed significant differences in the left external oblique, internal oblique muscles between before training, six weeks into training, and two weeks after the completion of training. There were significant interactions in the left oblique muscles according to the time and group. Conclusion: These findings have some value for patient rehabilitation and clinical applications and interventions through walking training.
Purpose: The purpose of this study was to measure the level of expectations regarding aging (ERA) and identify relationship between ERA and physical activity of middle aged adults. Methods: Participants were middle aged adults who resided in the community in three cities in Korea. Data were collected using questionnaires that contained items on individual characteristic, International Physical Activity Questionnaires (IPAQ), and behavior-specific cognitive factors including ERA-12. Hierarchical multiple regression was conducted to examine whether ERA would predict physical activity by controlling other factors. Results: The mean age of the participants was $51.1{\pm}6.9$ years. The mean score for ERA (possible range=0 to 100) was $40.04{\pm}14.31$. More than half of the participants (62.6%) were not engaged in health promoting physical activity. Gender, employment status and exercise confidence were associated with level of physical activity (F=7.14, p<.001, $R^2=.36$). After controlling for individual factors and behavior-specific cognitive factors, ERA was independently related to physical activity (F=7.19, p<.001, $R^2=.38$). Conclusion: The results demonstrate that individuals' belief about aging has effects on physical activity in Korean middle aged adults. Thus, nursing interventions which focused on ERA could help enhance physical activity in middle aged adults.
Kim, Ki Young;Dong, Jae Yong;Han, Seung Yeon;Lee, Kwang-Soo
Health Policy and Management
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v.27
no.1
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pp.47-55
/
2017
Background: This study purposed to analyze the effects of metabolic syndrome on the total medical charge of patients. Methods: 2013 National Health Insurance Service sample research database (eligibility database, medical database, and health examination database) was used for this study. Gamma regression was applied to analyze the effects of metabolic syndrome on the total medical charge and logistic regression was used to determine the probability of medical charge which was higher than the third quartile. Sociodemographic characteristics (age and household income), health behavior factors (smoking, drinking, exercise, and body mass index), and disease related factors (family history and metabolic syndrome) were included as the independent variables. Results: people who had metabolic syndrome spent more medical expenses than those without metabolic syndrome both in man and woman group. The standard regression coefficient was 0.09 (p< 0.001) in man with metabolic syndrome and 0.16 (p< 0.001) in woman. In addition, woman with metabolic syndrome spent more than the third quartile of medical charge. The odds ratios was 1.04 (p= 0.16) for man with metabolic syndrome and 1.18 (p= 0.013) for woman. Conclusion: people with metabolic syndrome spent more medical charge, so it will need to consider policy interventions for preventing the incidence and management of metabolic syndrome in Korean people.
Purpose: This study was conducted to assess the effects of robot-assisted gait training with visual feedback on gait, balance, and balance confidence in patients with chronic stroke. Methods: Thirty subjects with chronic stroke were randomly assigned to two groups: the experimental group (n=15) and the control group (n=15). The experimental group performed robot-assisted gait training for 30 minutes and the control group performed gait training with assisted devices training for 30 minutes after both groups performed conventional physical therapy for 30 minutes. Both groups performed the therapeutic interventions for 5 days per week, for a period of 4 weeks. For assessment of the 10 m walking test (10 MWT), Figure of 8 on the walk test (F8WT), Timed-Up and Go test (TUG), and Berg Balance Scale (BBS) were used to test the gait and balance, and the Korean version of the Activities-specific Balance Confidence Scale was used to test the balance confidence. Results: The experimental group showed significant improvement in the 10 MWT and the K-ABC (p<0.05), and the control group showed significant improvement in the BBS and the TUG (p<0.05). In four measurements, there were significant differences between the two groups (p<0.05), and the control group showed significant improvement in the F8WT at pre and post intervention (p<0.05). Conclusion: This study demonstrated that Robot-assisted gait training with visual feedback is an effective intervention for improving straight gait abilities and balance confidence, while the control group showed some improvement in curve gait and balance. Thus, we suggest both Robot-assisted gait training with visual feedback and gait training with assisted devices training exercise as a therapeutic intervention in chronic stroke rehabilitation.
Journal of the Korean Society of Physical Medicine
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v.11
no.2
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pp.115-121
/
2016
PURPOSE: Many studies have reported the improvement of cognition through physical activity among subject with dementia. This study aimed to whether the current studies supports that physical activity intervention is efficacious on cognitive performance in subject with dementia. METHODS: Two independent reviewers searched National assembly library, RISS, KISS (2005-2015) using the concepts of dementia, exercise, and physical activity. We included randomized controlled trials that examined the efficacy of physical activity in subject with dementia. A meta-analysis was performed to estimate the effect sizes cognition with CMA (Comprehensive Meta-Analysis, version 2.2.064) soft-ware program. Nine randomized controlled trials were included, providing data from 133 individuals and excluding those failing to criteria of this study. RESULTS: The meta-analysis showed that physical activity intervention had a rather small effect sizes of 0.36 (95% confidence interval 0.14-0.59) on cognition performance in subject with dementia. Outcome measurement were MMSE-K (Mini-mental state examination Korean version) and LOCTA (Loewenstein Occupational Therapy Cognitive Assessment). We found heterogeneous among studies and there was difference between the studies (Q = 19.63, d(f)=12, $I^2= 38.88$). CONCLUSION: The present analysis suggests that physical activity interventions have the low effect sizes on cognition performance in subject with dementia Further studies will be required to develop the various programs for improving the cognitive performance in subject with dementia.
Pain is one of the most frequent and disturbing symptom of cancer patients. And almost of cancer patients are afraid of a attacks of pain related to cancer. Caring for the cancer patient can be divided into two phases. The phase of "active treatment" involves various interventions-surgical, chemical or radiological- that are designed to prolong the patient's life. "Terminal care" is the period from the end of active treatment until the patient's death. But in the majority of clinical settings, cancer pain is not being managed adequately results from a lack of education about how to treat the cancer pain management in the safest and most effective way during terminal phase. Althought organic factors represent the most important cause of their pain, it is also important to deal with the patient's psychological reactions and to take account of his or her social and family environment if treatment for chronic cancer pain is to prove adequate. Thus we try to evaluate a kinds of cancer related to pain, degree of pain, effectiveness of drugs, and patient's responses to management. In regard to the satisfaction for pain relief in pain clinics at Pusan National University Hospital(PNUH) are about 70% in patients and 90% in family. Average life expectancy in cancer patients are about 140 days (3 days- 5.7 years). Cancer patients are complained of several discomfortness (above 30 kinds) such as, pain associated with cancer (75%), nausea and vomitting (38%), sleeping disorder (38%), anorexia (38%), dyspnea (32%), constipation (31%), etc. Distributions of cancer associated with pain are stomach cancer (21%), lung cancer (16%), cervix cancer (10%), anorectal and colon cancer (8.6%), hepatoma (8%), pancreatic cancer (3%). About 1/3 of patients are suffer from incident pain in 3~5 times in a day especially in moving, coughing, and exercise. Methods for drug delivering system before death are transdermal fentanyl patch (42%), intravenous PCA (21%), oral intake of opioid (17%), epidural PCA (14%), etc.
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