• 한국전문물리치료학회지
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• 제21권4호
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• pp.23-33
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• 2014

The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) ($n_1$=7) and control (FES) ($n_2$=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

• Journal of Korean Biological Nursing Science
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• 제22권4호
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• pp.232-248
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• 2020

Purpose: The purpose of this study was to develop and apply a motivation-strengthening obesity management program for obese subjects with visual impairment and evaluate its effects. Methods: The program development and evaluation periods were from March to August 2018. The study design was an experimental study of non-equality, control repeat design. 25 subjects in the experimental group participated in the 12-week obesity management program and the 26 people in the control group did not. Results: The motivation-strengthening obesity management program included stretching exercises for 30 minutes in the morning five times a week. In addition, counseling, education, and group discussions were continued once a week for motivational strengthening. Special custom exercises for blind patients were also completed once a week simultaneously. Both of these activities were continued for 50 minutes a week for a total of 12 weeks. Measurements were recorded periodically to identify the sustained effects of the program. The obese subjects with visual impairment improved their knowledge of obesity, perceived disability, self-efficacy of exercise, and quality of life related to obesity through the motivational obesity management program. Waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood sugar were also improved in obese subjects. Conclusion: The study findings indicate that this program could be an active intervention for the control of weight gain in participants with visual impairment. Therefore, the motivation-strengthening program based on the ADDIE (Analysis, Design, Development, Implementation& Evaluation) model could be an effective strategy for better health outcomes of obese subjects with visual impairment.

• 대한간호학회지
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• 제35권2호
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• pp.252-261
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• 2005

Purpose: The purpose of the study was to investigate the health status(present illness, ADL and IADL), health perception, and health promotion behaviors of low-income elderly who are receiving the visiting nurse service in the community. Method: The sample of the study was 735 elderly over 65years old with basic livelihood security, who were conveniently selected from 245 public health centers nation-wide. Data collection was done using a structured questionnaire through interviews by visiting nurses. Result: The average number of present illnesses in the study subjects was 4.18. The average scores of ADL and IADL were 15.903.39and 9.772.97 respectively, which indicates a relatively independent everyday life. However, $64.2\%$ of the subjects perceived their health status as 'not healthy'. In terms of health promotion behaviors, $77.8\%$ of the subjects had ceased smoking, $83.9\%$ stopped drinking, $56.4\%$ had a regular diet, $45.8\%$ received regular physical check-ups during the past two years, and $66\%$ received flu shots. Approximately $50\%$ of the subjects were practicing 3-4 health promotion behaviors. Significant factors associated with health promotion behaviors were ADL, IADL and self-efficacy. Conclusion: Health promotion programs which focus on regular diet, exercise, and regular physical check-ups should be developed to improve independence of everyday life and quality of life among low-income elderly.

• 대한간호학회지
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• 제45권1호
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• pp.14-24
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• 2015

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.

• 노동경제논집
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• 제40권2호
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• pp.1-29
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• 2017

본 연구는 동료(peer)에 대비한 학생의 상대적인 학업성취가 진로 결정에 어떠한 영향을 주는지를 살펴본다. 구체적으로 학교 내에서 학생들의 상대적인 수학 순위가 이과 선택에 미치는 영향을 분석하였다. 분석을 위해 서울시 소재 학생들의 패널데이터를 이용하였으며, 수학 성적을 통제하더라도 상대 순위가 낮은 경우 이과에 진학할 확률이 11%포인트 이상 감소함을 확인하였다. 높은 상대 순위는 여학생에게 추가적인 양의 이과 진학 효과를 나타내 상대 순위가 성별로 다르게 작용함을 보였다. 분석 결과에 따르면 상대 순위효과 중 약 12%만이 자신감과 같은 주관적 평가에 의해 설명되며, 이로 미루어보아 내신 성적을 통한 경로가 더 지배적일 것으로 추측할 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권11호
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• pp.4875-4883
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• 2016

Background and objective: Breast cancer-related lymphoedema (BCRL) is a disabling complication with long term impact on quality on life after breast cancer treatment. Its management remains a major challenge for patients and health care professionals; the goal of this overview was to summarize effects of different treatment strategies for patients with BCRL. Methods: A thorough search was undertaken to allow a systematic review or meta-analysis of treatments for BCRL. Two investigators independently selected studies and abstracted the data. Results: Combined physical therapy (CPT) with different combinations of surgery, oral pharmaceuticals, low-level laser therapy, weight reduction, mesenchymal stem cell therapy, kinesio tex taping, and acupuncture might be effective in reducing lymphoedema, but exercise demonstrated no obvious benefit. The results of direct comparisons showed CPT might be more effective than standard physiotherapy (ST). Manual lymphatic drainage (MLD) may not offer additional benefits to ST for swelling reduction, but could facilitate compression bandaging. MLD seemed to have similar effects with self-administered simple lymphatic drainage (SLD) or using an intermittent pneumatic compression pump (IPC). IPC might also not be associated with additional effectiveness for CPT. Efficacy of stem cell therapy vs. compression sleeve or CPT, as well as the effects of daflon and coumarin could not be established. Conclusion: Although many treatments for BCRL might reduce lymphoedema volume, their effects were not well established. The quality of many of the original studies in the included reviews was not optimal, so that in future randomized control trials are a high priority.

• 지역사회간호학회지
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• 제29권3호
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• pp.359-370
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• 2018

Purpose: The purpose of this study is to identify effects of the variables of Health Action Process Approach (HAPA) Model on physical activity. Methods: This study has conducted a systematic literature review and meta-analysis. Sixteen articles were searched through electronic databases (PsycINFO, PubMed, CINAHL, Web of science, Science Direct, RISS, KMBASE, KoreaMed, KISS, DBpia) and additional journals from 2000 to July, 2017. To estimate the effect size (ES), the meta-analysis of the studies was performed by using Comprehensive Meta-Analysis programs. Results: The overall effect size of the variables of HAPA on physical activity was median (ES=.28). Of the core variables of HAPA model, action control (ES=.43) showed the largest effect size, followed by coping self-efficacy (ES=.31) and planning (ES=.31).Additional variables were identified as preparatory behavior (ES=.39) and past physical activity (ES=.24). Through the moderator effect analysis, the effect size was higher in the volitional phase than in the motivational phase, and higher in the healthy group than in the patient group. The higher the proportion of males and the lower the age, the larger the effect size. Conclusion: This finding shows empirical evidence that all core variables of the HAPA model are useful for predicting physical activity. We propose the use of the HAPA model to develop physical activity promotion intervention.

• 디지털융복합연구
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• 제19권3호
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• pp.471-482
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• 2021

본 연구의 목적은 국내외 경도인지장애 노인의 비약물적 중재에 대한 통합적 문헌고찰을 통해 비약물적 중재 프로그램 개발을 위한 기초자료를 제공하기 위함이다. 국내외 경도인지장애 노인의 비약물적 중재연구에 대한 통합적 문헌분석 결과, 최종 16개의 논문이 선정되었다. 비약물적 중재 프로그램의 전반적인 경향은 모두 인지강화를 주목적으로 하되 국내연구는 운동요법 등의 신체적 활동보다 음악치료와 웃음요법 등의 정서적 활동이 병합된 경우가 많은 반면, 국외연구는 정서적 활동보다는 신체적 활동을 병합한 연구가 많았다. 중재 프로그램 효과는 결과변수에 따라 다르게 나타났는데 일차적 변수는 인지기능과 우울로 나타났고, 이차적 변수는 신체적 기능, 일상생활수행능력과 자기효능감에 중재 효과가 있는 것으로 나타났다. 본 연구결과를 토대로 경도인지장애 노인의 치매예방을 위한 다양한 비약물적 중재 프로그램 개발을 통해 임상현장에서 적용할 수 있는 다학제적 접근에 기여할 수 있을 것이다.

• Journal of Oral Medicine and Pain
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• 제32권4호
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• pp.441-447
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• 2007

악관절 내장증은 관절과두와 관절원판이 이루는 복합체의 기능적 관계가 파괴되어 관절원판이 변위되는 것이다. 관절원판의 변위는 전내방으로의 변위가 가장 흔하며, 정복성 관절원판 변위와 비정복성 관절원판 변위로 나뉘어진다. 악관절 내장증환자의 치료로는 교합안정장치, 물리치료, 운동요법, 행동요법 등의 보존적 치료법을 우선 고려하여야 하고, 충분한 기간 동안의 보존적 치료에도 증상의 변화가 적은 경우에 외과적 처치를 고려해 볼 수 있다. 악관절 수조작술은 앞서 언급한 보존적 치료법들과 함께 시행하는 보존적 술식으로 전방으로 변위된 관절 원판의 정복을 도모하고, 원판후조직의 적응을 유도하기 위해 시행한다. 전통적으로 Farrar의 방법을 널리 이용해왔으며, 이에 대한 많은 성공적 임상 사례들이 보고된 바 있고, 그 밖에도 몇몇 수조작법들이 소개된 바 있다. 그러나 전통적인 방법은 술자에 의해 이루어지는 것으로 환자가 병원에 내원할 경우에만 시행할 수 있어 수조작법의 치료 효과를 높이기 위해 환자가 스스로 시행할 수 있는 방법의 필요성이 제시되었다. Minagi, Mongini, Suarez 등은 환자 스스로 시행할 수 있는 수조작법을 소개한 바 있으나, 전통적인 수조작법과 비교한 자가 수조작법의 효과에 대한 연구는 현재까지 보고된 바가 없다. 본 연구에서는 Minagi, Mongini, Suarez 등에 의해 소개된 환자 스스로 시행할 수 있는 수조작법을 보완하여, 임상적으로 활용이 가능한 자가 수조작법을 소개하고 내원한 환자에 대하여 치과의사가 직접 실시하는 전통적인 수조작법과 환자의 교육을 통해 환자 자신이 일상에서 시행하도록 한 자가 수조작법이 악관절 자기공명영상검사로 확진된 비정복성 관절원판 전방변위로 인한 개구제한 환자들의 치료 성과에 어떠한 영향을 미치는지 알아보고자 하였다. 연구를 위해 구강내과에 2002년 12월부터 2004년 11월까지 측두하악관절장애로 진단 받은 환자 중 개구제한이 관찰되고 악관절 자기공명영상 검사에서 비정복성 관절원판 전방변위가 확진된 뒤 물리치료, 운동요법, 행동요법, 교합안정장치 및 수조작법을 시행하여 치료가 종결된 환자들을 대상으로 하였다. 초진시 환자는 개구제한과 함께 통증 등의 다양한 증상을 함께 호소하였고, 이에 따라 치료의 종결은 개구량의 증가와 더불어 환자의 주관적 불편감이 더 이상 존재하지 않아 내원을 중단할 수 있을 때로 결정하였다. 환자들의 의무 기록을 토대로 치료기간, 개구량의 증가, 주관적 증상의 개선 정도를 수조작법의 종류에 따라 후향 조사하였다. 전통적인 수조작법을 시행한 군과 변형된 자가 수조작법을 시행한 군의 차이를 분석하기 위하여 chi-squared test, Mann-Whitney U-test를 시행하였다. 치료 결과 개구량이 40 mm 이상으로 증가한 환자의 분포는 전통적인 수조작법을 시행한 군(42.9%)보다 자가 수조작법을 시행한 군(69.9%)에서 더 높은 경향을 보였으나, 그 차이가 통계적으로 유의하지는 않았다. 치료기간에 있어서는 치료의 종결 시점을 40 mm이상의 개구량이 확보되고 환자가 초진시 호소한 주관적 불편감이 해소된 때로 하였고, 이에 따라 치료가 종결된 환자의 치료기간은 전통적인 수조작법을 시행한 군($61.0{\pm}38.0$ 주)보다 자가 수조작법을 시행한 군($29.2{\pm}12.3$ 주)에서 통계적으로 유의한 수준으로 짧았다. (p<0.01) 결론적으로, 비정복성 관절원판 전방변위로 인한 개구장애 환자의 치료에 있어서 자가 수조작법의 시행은 환자가 수조작법을 교육받고 정해진 바에 따라 매일 시행하는 치료과정을 통해 개구량을 증가시킬 수 있고, 전통적인 수조작법에 비하여 전체적인 치료 기간을 단축시킬 수 있는 효과적인 치료법이라고 할 수 있다.

• 대한간호학회지
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• 제29권2호
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• pp.314-327
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• 1999

In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior. and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program According to the study results. target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior. and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical. psychological. and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management. skill for problem solving, skill for setting goals. skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as “joint protection, and maintenance of pain management behavior”, “maintenance of regular exercise”, and “promotion of coping skill in psychosocial dimension” are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives. the final objectives such as “minimization of physical symptoms and signs”, “maximization of psychological function”, and “maximazation of role performance in social domain” could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.