• 한국전문물리치료학회지
• /
• 제14권1호
• /
• pp.46-54
• /
• 2007

The purposes of the present study were to determine the difference of functional outcome, and to identify factors associated with functional difference in patients with stroke. The sample consisted of 56 stroke patients who had received physical therapy at the physical therapy unit of the Dongeui Medical Center in Busan city between January 2000 and June 2002. Stroke patients were evaluated by physical therapists 3 times; The first day in physical therapy (PT) (T1), one month after the first day in PT (T2), and two months after the first day in PT (T3). Functional status was assessed with the Functional Independence Measure (FIM) instrument, a validated instrument for documenting the severity of disability and assessing the outcome of rehabilitation treatment. Functional gain was calculated over T2-T1, T3-T1, and T3-T2. SAS statistical software was used for the analysis. The Student's t-test, paired t-test, analysis of variance (ANOVA/Tukey and Scheffe), and analysis of covariance (ANCOVA) were used to examine the functional difference in variables. Repeated measures ANOVA was also used to analyze the functional difference by time (T1, T2, and T3). Multiple regression analysis was performed to determine the effects of independent variables on the difference of functional outcome as defined by the FIM score. A total of 56 stroke patients were evaluated, their average age${\pm}$standard deviation was $61.6{\pm}9.3$ years (range: 40~81 yr). The functional status of patients who received physical therapy for about 2~3 months was significantly improved (mean FIM scores, $20.5{\pm}1.8$, $28.9{\pm}1.9$, and $8.41{\pm}1.1$ points for each time period, respectively) (p<.0001). Diabetes was significantly associated with the FIM score for T2-T1 (p<.05). The type of diagnosis was significantly associated with the FIM score for T3-T1 (p<.05). Gender, smoking, and the FIM score on admission were significantly associated with the FIM score for T3-T2 (p<.05). In conclusion, gender, smoking, diabetes, the type of diagnosis, and the FIM score on admission were significantly associated with improved FIM scores. We recommend that further research should explore the functional outcome by using larger sample sizes, longer follow-up periods, and more sensitive assessment instruments.

• 한국전문물리치료학회지
• /
• 제14권2호
• /
• pp.53-60
• /
• 2007

The objective of this study was to discover the effects of the short-term home visiting physical therapy program involving patients with some chronic brain disorders at Gimhae City, Kyongnam. Recovery of activities of daily living (ADL) is a very important factor of rehabilitative procedures, and Functional Independence Measure (FIM) is a useful standard of evaluation for it. The FIM is widely used in brain disorder research because it measures real functional activities of daily living. We applied the physical therapy exercise program twice per week (10~15 times repeatedly); a warm-up and cool down exercise performed every ten minutes by active & active-assistive ROM and stretching exercises. Main exercises were composed of getting up & laying down in bed, standing training, walking exercise in the room, and window or wall sliding exercise using affected upper limbs for a total duration of 30 minutes. We collected the data from 20 patients with chronic brain disorders at his/her home and analyzed by means of SPSS/PC+ program (Ver. 10.0). After the six week long physical therapy exercise program, the average was $56.10{\pm}22.59$ point compared with initial $50.55{\pm}19.12$ point by FIM, improved functional ADL ability about 5.55 point, and these changed scores were statistically significant (p=.000). We also studied another factor regarding patient's satisfaction. The majority of subjects (10 people) rated the program with the maximum score of ten points (50.0%), and three people rated it a seven point program (15.0%), the other two subjects gave a rating of nine and eight points (10.0%). Because the program was effective at improving the physical ADL ability and satisfaction of each subject, we suggest continual development and implementation of a home visiting physical therapy program. Further study should involve a longer period of observation with a larger population that is involved in an individually designed home physical therapy program.

• 대한조선학회논문집
• /
• 제36권3호
• /
• pp.107-114
• /
• 1999

설계공리는 독립공리와 정보공리로 이루어졌는데, 독립공리를 이용하면 개념설계 단계에서 기능과 구조의 관계를 고려하여 설계의 기본적인 개요을 잡는데 유용하며, 구조가 결정이 된 후에 기능요구를 잘 만족시키기 위한 설계변수들의 결정과정에서, 설계의 정보량을 최소화하는 입장에서 정보공리를 이용함으로서 설계 시에 설계공리의 적용이 가능하리라 본다. 본 연구에서는 조선분야의 설계문제에 설계공리를 적용하여 봄으로써 설계공리의 응용 가능성을 고찰하였다. Thruster의 개념설계 예제에서는 독립공리를 사용하여 기능요구와 설계변수의 분석이 어떻게 이루어지는가를 보였고, 주기관 선정 예제에서는 대안들을 선택하는 방법으로 정보공리가 효과적으로 이용될 수 있음을 보였다. 또 설계변수의 선택과 변경량이 중요한 상사설계에서도 바지선의 예를 통하여 설계공리가 유용하게 쓰일 수 있음을 보였다. 그러나 초기에 제한조건과 기능요구를 모두 파악하기 어려워 점진적이며 반복적인 설계과정을 거치는 선박과 같은 대형 구조물인 경우에는 설계공리의 적용에 한계가 있음도 파악하였다.

• The Journal of Korean Physical Therapy
• /
• 제24권6호
• /
• pp.398-404
• /
• 2012

Purpose: This is designed to study the effect of weight-support walking training through motor learning on motor functions of children with cerebral palsy, in particular their activity of daily living and balance. Methods: Thirteen children with spastic cerebral palsy, at gross motor function classification system (GMFCS) levels III~IV, underwent treadmill walking training. It used principles of weight support, 4 times a week for 7 weeks, 10 minutes at a time, before and after neurodevelopmental physical therapy. Everyday functions were measured using Functional Independence Measure for Children (Wee-FIM). The ability to keep their balance was measured using electronic measuring equipment from good balance system and the assessment was made before and after the experiment. Results: There were significant differences (p<0.05) between pre and post experiment levels of functional independence in everyday life, in self-care activities, mobility, locomotion and social cognition. With regard to changes in standing balance, there were significant differences before and after the experiment (p<0.05) in GMFCS level III. There was a reduction in the agitation velocity in the x- and y-axes which measures the left-to-right shaking; in GMFCS level IV, velocity moment was reduced. Conclusion: Walking training using a treadmill can help improve the everyday activity and balance in children with spastic cerebral palsy. It can also be served as a useful purpose as a method of intervention in pediatric care.

• 대한물리치료과학회지
• /
• 제6권4호
• /
• pp.251-262
• /
• 1999

This study is designed to evaluate the effects of aggressive fine motor exercise of unaffected hand in the hemiplegic patients. The 36 hemiplegic patients were classified into two groups: The experimental 18, who were treated by aggressive fine motor exercise in unaffected hand and the control, 18, who were treated by conventional exercise program. We evaluate the effects of aggressive fine motor exercise by Functional Independence Measure(FIM) and Jebsen Hand Function Test(JHFT) after 6 weeks program. After exercise program, the experimental group showed score change from $43.05{\pm}15.68$ to $58.05{\pm}17.12$ in FIM score and from $24.12{\pm}22.03$ to $55.44{\pm}21.50$ in Jebsen, and the control showed score change from $51.11{\pm}22.61$ to $57.50{\pm}23.66$ in FIM score and from $40.88{\pm}21.17$ to $52.77{\pm}19.42$ in Jebsen. The experimental group had significantly higher score in FIM and JHFT than that of the control group. The aggressive fine motor exercise is beneficial in unaffected hand in the hemiplegic patients.

• 대한간호학회지
• /
• 제34권8호
• /
• pp.1402-1408
• /
• 2004

Purpose: The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. Methods: The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Results: Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Discussion: Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

• 대한물리치료사협회지
• /
• 제13권1호
• /
• pp.5-17
• /
• 1992

Depression in Spinal Cord Injury Patients Kang, Soon Hee, M.Ed., R.P.T. Dept. of Rehabilitation Medicine, Kyung-Hee University Medical Center Depressions have the potential to affect adversely the rehabilitation of patients with spi-nal cord iniury. The present study examined depression, functional independence, and demographic and medical characteristics for 49 spinal cord injury(SCI) patients. This investigation involved the administration of the Beck Depression Inventory, the Modified Barthel Index, and aquestionnaire consisted of 14 items, The results were as follows .1. Compared to normal subjects, SCI patients had significantly higher BDI scores.2. When the cut-off point of HDI scores was assumed 21, 26.1% of normal subjeets and 75.5% of SCI patients appeared to be depressed. Depression in SCT patients were not related with age, sex, marital status, injury evel, severity, duration, pain, functional independence and medical charge. Depression in SCI patients were related with education level, economic level, age at injury, motivation. Depression in normal subjects were related with age, education level, economic level, but not related with sex, marital status. There were significant differences at 30 items of BDI between normal subjects and SCI patients. The items were as fellows . 1 sadness, 2 pessimism, 3 failure, 4 dissat-isfaction, 5 guilt, 6 punishment. 7 self-dislike 9 suicidal, 10 crying, 11 irritability, 12withdrawl, 13 indecisive, 14 self-image, IS work inhibition, 16 insomnia, 17 fatigue,18 anorexia, 19 weight loss, 20 hypochondria, 21 libido loss.

• 한국전문물리치료학회지
• /
• 제18권4호
• /
• pp.11-18
• /
• 2011

The aim of this study was to analyze the relationship between physical impairments and daily activities on the basis of the outcome measurements in stroke patients. Seventy-six stroke patients participated in this study. Two physical therapists evaluated 3 clinical common measurements, i.e., the Fugl-Meyer Assessment (FMA), the Berg Balance Scale (BBS), and the Functional Independence Measure (FIM). Multiple regression analysis was used, as the dependent variables were the BBS and FIM; the independent variables were post-stroke duration, FMA of Upper Extremity (FMU), and FMA of Lower Extremity (FML). In the regression equation of the BBS, the coefficient of determination ($R^2$) was .383, and the FML was found to be the most important variable for determining the BBS score. In the regression equation of the FIM, $R^2$ was .531, and the FML was found to be the most important variable for determining the FIM. These results suggest that there is a need to determine the function of activities on the basis of the physical impairments of stroke patients. More variable measurement tools on the levels of body function and structure, as well as activity limitations are required.

• 한국콘텐츠학회논문지
• /
• 제9권9호
• /
• pp.287-294
• /
• 2009

연구를 통하여 뇌졸중 환자에서 알렌인지수준과 인지기능, 일상생활활동 및 상지기능과의 상관관계를 분석하고자 하였다. 연구 대상자는 뇌졸중 환자 38명으로 인지기능은 알렌인지주순검사(Allen Cognitive Level Test) 와 한국형 간이 정신상태검사(Mini-Mental Screening Exam-Korea)로, 일상생활활동은 기능적독립성측정(Functional Independence Measure)로, 뇌졸중 상기 기능은 뇌졸중 상지기능검사(Manual Function Test)로 검사하였다. 피어슨 상관관계 분석을 이용하여 상관관계를 분석하였다. 알렌인지수준과 한국형 간이정신상태검사, 기능적독립측정, 뇌졸중 상기기능검사 간에 상관관계가 유의하였다(p<.05). 본 연구에서는 알렌인지수준 검사와 일상생활활동과의 상관성 및 인지평가도구로서의 유용성을 제시하였고 편마비 환자 적용에 있어 문제의 가능성과 이에 따른 연구 필요성을 제기하였다.

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2004년도 추계학술대회 논문집
• /
• pp.82-86
• /
• 2004

To cope with the challenge from global market characterized by frequent changes in requirements, manufacturing enterprise should be able to promptly adjust its manufacturing system accordingly. Therefore, it is important to provide manufacturing system designer with an appropriate methodology to (re-)design a manufacturing system subject to requirements change. Axiomatic design theory focuses design activity mainly on functional consideration rather than physical, and has been known as effective especially in the conceptual design phase. This paper introduces an approach to apply the axiomatic design principle to manufacturing system design. It is shown that a new design solution can be reached quickly by finding design parameters for the added or revised functional requirements and thus achieving a set of functional requirements as well as design parameters that satisfy the independence axiom. Some illustrative examples are also given.