• 한국병원경영학회지
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• 제29권3호
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• pp.1-10
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• 2024

Purposes: When rehabilitation services are provided remotely using information and communication technologies to patients living at home, there is an advantage in providing rehabilitation services to individuals in their everyday social and physical environment, which can improve functional outcomes and satisfaction. The purpose of this study was to analyze the effectiveness of the pilot project by analyzing the outpatient and inpatient medical use and expenses of patients who participated in the rehabilitation patient home-based care pilot project. Methodology: To analyze the effectiveness of the home-based care pilot project for rehabilitation patients, health insurance claims data from the Health Insurance Review and Assessment Service was used. The subjects of analysis were patients who had undergone major lower extremity joint replacement surgery, including hip, knee, and ankle joint replacement surgery, and patients who had lower extremity fracture surgery, which were the targets of the rehabilitation patient home-based care pilot project. To compare medical use and expenses between patients participating in the rehabilitation patient home-based care pilot project and those not participating, chi-square test, t-test, and multiple regression analysis were performed. Findings: As a result of analyzing the number of medical use cases and expenses of patients who participated and those who did not participate in the rehabilitation patient home-based care pilot project, the average outpatient medical use and outpatient medical expenses per person for participating patients were lower than those for patients who did not participate. The average hospitalization cost per person and the average length of stay per person were also lower than those of patients who did not participate. Practical Implications: Home-based care for rehabilitation patients continues to provide medical services at home, not at medical institutions, and can be expected to reduce readmissions and complications by resolving patients' emergency situations at home or on their own, thereby reducing medical use.

• 한국전문물리치료학회지
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• 제10권1호
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• pp.139-158
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• 2003

This study evaluated the community-based rehabilitation services provided by the Wonju Public Health Center from Jan. 2000 to Dec. 2002. Ninety-four persons with disabilities dwelling in the community participated and the surveys were completed in an interview during home visits. The respondents' demographic, socio-economic, and medical characteristics, rehabilitation service received, willingness to receive home-visit rehabilitation services, and satisfaction with the rehabilitation services were analyzed by frequency and percentage. A Likert scoring system consisting of five agreement-disagreement categories was applied to each item, consisting of Very Satisfied, Satisfied, So-So, Poorly Satisfied, and Very Poorly Satisfied. The major findings were as follows: 1) The rehabilitation services used included medical rehabilitation (26.9%), followed by social assistance (23.5%), diagnosis by a physician at home (17.3%), medical examination (12.3%), housekeeping services (6.2%), and vocational and educational rehabilitation (3.5%). 2) Of the medical services, the respondents desired physical therapy at home and free rental of rehabilitation equipment, such as wheelchairs, canes, walkers, the most, followed by home visit occupational therapy, nursing services, and oriental medicine service in descending order. 3) Some of the respondents expressed so-so satisfaction (50.0%) or dissatisfaction (16.9%) with the rehabilitation services provided by the Wonju Public Health Center. These findings should prove useful when planning or extending community-based rehabilitation programs for the homebound disabled in the community.

• 국제물리치료학회지
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• 제12권1호
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• pp.2267-2271
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• 2021

Background: Recently, a new home-based dysphagia rehabilitation method using information and communications technology (ICT) has been reported, but clinical evidence is still lacking. Objectives: To investigate the effects of home-based dysphagia rehabilitation using ICT on tongue muscle strength and volume in patients with developed dysphagia after stroke. Design: Randomized controlled trial design. Methods: Twenty patients who developed dysphagia after stroke were enrolled. The experimental group received dysphagia rehabilitation in the form of ICT-based home care. In contrast, the control group received traditional rehabilitation based on swallowing under the supervision of occupational therapists. All interventions were conducted five times a week for four weeks. Results: Both groups showed statistically significant increases in tongue muscle strength and volume after the intervention (P<.05, both). However, there were no significant differences in tongue strength or volume between the two groups after the intervention (P>.05, both). Conclusion: Home-based dysphagia rehabilitation using ICT showed effects similar to those of conventional swallowing rehabilitation in patients who developed dysphagia after stroke. These findings suggest that dysphagia rehabilitation can be conducted at home without the help of a therapist.

• 재활간호학회지
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• 제19권2호
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• pp.82-99
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• 2016

Purpose: The purpose of this study was to review systematically the effects of home based pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) patients using qualitative synthesis. Methods: Studies designed randomized controlled trials were identified to extract data and to assess the quality of studies in 8 domestic and 3 foreign search engines, and hand search reference reviews. Results: A total of 9 studies met the inclusion criteria. Overall, the methodological quality of the studies ranged from average to poor. Home based pulmonary rehabilitation consisted of exercise, education, and psychosocial interventions. Several exercises such as aerobic, strength, respiratory muscle training, and flexibility were used in home based pulmonary rehabilitation for COPD patients. Upper muscle exercise and walking were the most frequently used exercises. The most common topics for education were 'knowledge of the illness' and 'drug management'. Walking distance test (WDT) and quality of life (QoL) were the most frequently measured as the dependent variables to evaluate rehabilitation outcomes, followed by pulmonary function test (PFT) and dyspnea. WDT was the most effective outcome, followed by dyspnea, QoL and PFT. Conclusion: This study informed about the details of scientific and effective home based rehabilitation programs in COPD patients for future researchers and clinicians. These findings can help expand the recognition and accessibility of home based rehabilitation in COPD patients.

• The Journal of Korean Physical Therapy
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• 제32권4호
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• pp.258-265
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• 2020

Purpose: This study examined the legal basis related to a physical therapist's home-based rehabilitation. Methods: The policy data were referenced to the comprehensive plan for national health promotion and the guidebook Community Health Promotion Project issued by the Korea Health Promotion Institute and other institutes. The legal data were referenced to the Bill information system on the National Assembly website. Results: The physical therapist's home-based rehabilitation did not have a legal basis in the community-based rehabilitation project (CBR) of the HP 2020 project. On the other hand, according to the Home health care part of the community health promotion project that began in 2013, physical therapists were allowed to play a role from 2020 under Article 16-2 (Public Officials in Exclusive Charge of Visiting Health Management) of the REGIONAL PUBLIC HEALTH ACT. Conclusion: Policies and laws are being developed in the field of healthcare, but the necessary policies and laws in the field of rehabilitation are still insufficient. A bill to rehabilitate in a variety of fields and spaces by modifying the scope of work of physical therapists will be needed.

• 성인간호학회지
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• 제14권3호
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• pp.368-377
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• 2002

Purpose: The purpose of this study was to analyze the trend of research on the use of home-based pulmonary rehabilitation. Method: Using Medline and CINAHL search engine, experiemental research, titled as 'home-based pulmonary rehabilitation' and 'chronic lung disease', statistics were collected. The total 29 experimental studies published between 1981 to 2000 were selected and analyzed according to the ATS guidelines. Result: 1) The study samples in research were mostly of men, whose lung function was moderate to severe. 2) The total period of the intervention program varied from 5 to 12 week. The program included excercise intervention and educational intervention. Psychosocial intervention was minimal. 3) The outcome of the home-based pulmonary rehabilitation had been measured mostly by physical aspects. Quality of life and cost were less frequently measured. 4) In terms of effectiveness of the home based pulmonary rehabilitation program, physiologic outcome, such as lung function and hematologic markers, there was more 'no effect' than 'positive effect', whereas there was more 'positive effect' in decreasing dyspnea, improving excercise capacity, and improving quality of life. Conclusion: Based on these findings, future research on home-based pulmonary rehabilitation should be emphasized and provide standardized protocol, including psychosocial intervention, and analyses on cost and quality of life.

• The Journal of Korean Physical Therapy
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• 제11권1호
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• pp.179-185
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• 1999

The Purpose of this study was to review the necessity of home care service for the handicapped. The Present momentum for home care for the handicapped become when the circulating rehabilitation service center for the handicapped was designated by the government in Korea. That was 1992. Home care service is a burgeoning segment of Korea health Service, driven by factors which include an expanding elderly population and increasing the disabled persons. To ensure quality of life for the disabled persons with diminishing financial resources allocated to health me, it is essential that community based rehabilitation and home care service be extended.

• 로봇학회논문지
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• 제18권4호
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• pp.376-384
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• 2023

In this paper, we introduce an upper extremity rehabilitation robot, NREH (NRC End-effector based Rehabilitation arm at Home). Through NREH, stroke survivors could continuously exercise their upper extremities at home. NREH allows a user to hold the handle of the end-effector of the robot arm. NREH is a end-effector-based robot that moves the arm on a two-dimensional plane, but the tilt angle can be adjusted to mimic a movement similar to that in a three-dimensional space. Depending on the tilting angle, it is possible to perform customized exercises that can adjust the difficulty for each user. The user can sit down facing the robot and perform exercises such as arm reaching. When the user sits 90 degrees sideways, the user can also exercise their arms on a plane parallel to the sagittal plane. NREH was designed to be as simple as possible considering its use at home. By applying error augmentation, the exercise effect can be increased, and assistance force or resistance force can be applied as needed. Using an encoder on two actuators and a force/torque sensor on the end-effector, NREH can continuously collect and analyze the user's movement data.

• 한국전문물리치료학회지
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• 제9권2호
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• pp.61-81
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• 2002

The purposes of this research were to investigate home care rehabilitation services in rural areas and to collect basic data about disabled persons necessary when for carrying out rehabilitation services. Respondents were selected from six of a total of eight townships (Myon) and one town (Eup) in the Wonju city area. Wonju is in Kangwon Province (Do). Of a total of 338 names provided by the Myon offices, 298 persons were located and included registered and non-registered persons. Conditions included stroke, spinal cord injury, and cerebral palsy in addition to disabilities classified as first, second or third degree, in the case of registered cases. Respondent demographic characteristics, medical characteristics, rehabilitation service needs, willingness to receive rehabilitation service and individual opinions regarding rehabilitation services were analysed by frequency and percentage. The results were as follows: 1) Rehabilitation services received by disabled persons living at home in the rural areas surrounding Wonju city were medical rehabilitation (41.7%), diagnosis (36.5%), rehabilitation assistive devices (7.6%), social assistance (7.1%), rehabilitation counseling (3.0%), vocational rehabilitation (1.8%), educational rehabilitation (1.6%) and housekeeping services (0.5%). The majority of rehabilitation services were medical rehabilitation provided at hospitals and oriental medicine hospitals. 2) Sixty point eight percent of respondents expressed their willingness to receive home care rehabilitation services. Needs expressed were highest for medical rehabilitation (27.0%), followed by social assistance (19.4%), medical examination (12.4%), physician-generated diagnosis in the home setting (11.6%), sociopsychological rehabilitation (9.3%), vocational rehabilitation (7.6%), rehabilitation engineering (6.0%), educational rehabilitation (3.3%), and housekeeping services (3.3%). 3) Rehabilitation service needs were analyzed by severity classification: 65.8% of first degree, 62.7% of second degree and 55.6% of third degree disability classification, and 62.7% of non-registered disabled individuals responded that rehabilitation service was necessary. 4) Rehabilitation service needs were also analyzed by diagnosis: 62.6% of stroke, 85.5% of amputation, 60.0% of spinal cord injury and 52.4% of traumatic brain injury respondents answered positively that they were willing to receive rehabilitation service if it were to be provided. Rehabilitation service utilization data of disabled individuals living at home in rural areas were investigated and their rehabilitation needs analyzed. This critical information can be used when community-based rehabilitation programs for disabled persons living at home are planned for provision out of a public health center or when community-based rehabilitation welfare policy is formulated.

• The Journal of Korean Physical Therapy
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• 제27권1호
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• pp.68-77
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• 2015

Purpose: This study was conducted in order to explore home visiting therapists' self-perceived role, problems, and supplement points of the home-based rehabilitation (HR) program based on the community-based rehabilitation (CBR) model. Methods: Four home visiting physical therapists, who conducted the HR program, participated in this study. After completion of the HR program, in-depth interviews were conducted using a semi-structured questionnaire for participants to explore their self-perceived role, problems, and supplement points of the HR program. Results: Participants regarded the role of the HR program as for "the linkage between recipient & society", "maintenance & improvement of recipients' physical function", and "education of recipient about the way of self rehabilitation". The problems and supplement points were derived from all phases of the HR program, including "human & material resources", "training program for human resources for HR service", "selection of recipient of HR service", "contents of the intervention for HR service", and "duration of HR service". Conclusion: These findings indicate that participants well recognized the intention of the HR program based on the CBR model, and suggest that high-quality human resources with rich expertise and experiences, a training program for HR service led by experts, and selection of recipients led by experts are necessary for an effective HR program. In addition, strategies and capacities specified to HR service should be identified, and applied to the training program for human resources for HR service. The results of this study could provide useful information when the government decides on the next guideline for home visiting health service.