• Title/Summary/Keyword: Functional Independence

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Difference of Functional Outcome and Related Factors in Patients With Stroke (일부 뇌졸중 환자의 기능변화 및 관련요인)

  • Yi, Seung-Ju;Jeong, Seong-Yeong
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.46-54
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    • 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.

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Effects on Improvement of Activities of Daily Living Through Short-Term Home Visiting Physical Therapy (단기 가정방문물리치료 시행이 일상생활동작의 개선에 미치는 효과)

  • An, Duk-Hyun
    • Physical Therapy Korea
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    • v.14 no.2
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    • pp.53-60
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    • 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.

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Application of Design Axiom to Marine Design Problems (조선분야에서의 설계공리의 응용)

  • Y.S. Song;Y.S.Yang;B.S. Jang
    • Journal of the Society of Naval Architects of Korea
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    • v.36 no.3
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    • pp.107-114
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    • 1999
  • Design Axiom proposed by N. P. Such consists of Independence Axiom & Information Axiom. Based on the Independence Axiom, it is very useful specially for early design stage such as conceptual design to generate the design alternatives by considering both functions and structures of product. Since the Information Axiom shows that the design solution should have a least information to be the best one among the many alternatives, this axiom can be used for the best selection purpose during the preliminary design stage. In this paper, the possibility of Design Axiom in marine design application is checked by carrying out three examples of marine design. In the conceptual design of thruster, it is proven to use the Independence Axiom very effective by relating directly functional requirements with design parameters, one by one. In main engine selection example, Information Axiom is used to select best solution among alternatives by choosing the one having the minimum information quantity. For similarity based design in which the selection of changing design variables and the amount of those are important, it is proved that design axiom applied to Barge design case would be very effective and useful. As functional requirements and constrains were not clarified in early design stage, design axiom shows some difficulty for larger system design like ship which is basically carried out by an incremental and iterative process.

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The Effect of Weight-support Treadmill Training on the Balance and Activity of Daily Living of Children with Spastic Diplegia

  • Choi, Hyun-Jin;Nam, Ki-Won
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.398-404
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    • 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.

The study for Functional Independence Measure score by fine motor exercise of unaffected hand in the hemiplegic patients (편마비 환자에서 건측 수부의 적극적 미세 운동 제공을 통한 기능적 독립성의 증가에 관한 연구)

  • Chae, Jung-Byung
    • Journal of Korean Physical Therapy Science
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    • v.6 no.4
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    • pp.251-262
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    • 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.

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Self-Care in Elders with Dementia: A Concept Analysis

  • Yeom Hye-A
    • Journal of Korean Academy of Nursing
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    • v.34 no.8
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    • pp.1402-1408
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    • 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.

척수손상환자의 우울성향에 관한 연구

  • Gang, Sun-Hui
    • Journal of the Korean Physical Therapy Association
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    • v.13 no.1
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    • pp.5-17
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    • 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.

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Assessment of the Influence of Physical Impairments on Activities in Persons With Stroke

  • Woo, Young-Keun
    • Physical Therapy Korea
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    • v.18 no.4
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    • pp.11-18
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    • 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.

Correlation between ACLT and FIM, MMSE-K, and MFT in Stroke Patients (뇌졸중 환각에서 알렌인지수준과 일상생활활동, 인지기능 및 상지기능의 상관관계)

  • Lee, Sang-Heon
    • The Journal of the Korea Contents Association
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    • v.9 no.9
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    • pp.287-294
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    • 2009
  • The purpose of this research is to test the relationship between ACLT(Allen Cognitive Level Test) and FIM(Functional Independence Measure), MMSE-K(Mini-Mental State Examination), and MFT(Manual Function Test). 38 elderly persons with stroke were recruited. Pearson Correlation Coefficients is used for correlation test. There is statistically significant correlation between ACLT and FIM, MMSE-K, and MFT(p<.05). This results identified the relationship between cognitive function and activities of daily living, indicated the usability of ACLT as a cognition assessment tool and the need of research for it's application in stroke patients.

Application of Axiomatic Design Theory in Manufacturing System Design (공리적 설계 기법을 이용한 생산시스템 설계 지원 방안에 대한 고찰)

  • 백태진;강무진
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.82-86
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    • 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.

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