• 한국전문물리치료학회지
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• 제2권2호
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• pp.85-97
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• 1995

When applying FES to patients, proper evaluation must be performed prior to treating patient. Patients with thoracic lesions between $T_4{\sim}T_{12}$ are suitable for FES. However, these patients must have excitability of the leg muscles. Thus, excitability testing is an essential part of the screening program(stimulation at 80V gives a response). Before standing or walking is attempted the patients must perform restrengthening exercise, so that the Quadriceps muscle group minimum strength is 40 Nm (corresponding to a manual grade of F+ to G). After that walking and standing can be attempted. The effects of FES are as follows: prevents pressure sores; development and maintenance of muscle properties; prevents disuse atrophy and contractures.

• International Journal of Heart Failure
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• 제6권3호
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• pp.107-116
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• 2024

Frailty is highly prevalent among patients with heart failure (HF) and independently predicts adverse outcomes. However, optimal frailty definitions, assessments, and management in HF remain unclear. Frailty is common in HF, affecting up to 80% of patients depending on population characteristics. Even pre-frailty doubles mortality risk versus robust patients. Frailty worsens HF prognosis through systemic inflammation, neurohormonal changes, sarcopenia, and micronutrient deficiency. Simple screening tools like gait speed and grip strength predict outcomes but lack HF-specificity. Comprehensive geriatric assessment is ideal but not always feasible. Exercise, nutrition, poly-pharmacy management, and multidisciplinary care models can help stablize frailty components and improve patient-centred outcomes. Frailty frequently coexists with and exacerbates HF. Routine frailty screening should guide supportive interventions to optimize physical, cognitive, and psychosocial health. Further research on HF-specific frailty assessment tools and interventions is warranted to reduce this dual burden.

• 대한물리의학회지
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• 제12권4호
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• pp.73-82
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• 2017

PURPOSE: Proprioceptive Neuromuscular Facilitation (PNF) has been shown to improve body function and activity/participation in people with functional dysfunctions. This study evaluates if active exercise using theraband in PNF pattern may induce similar benefits as exercise using manual PNF pattern performed by physiotherapists on promoting mobility, balance and fear of fall in community-dwelling elderly. METHODS: Twenty-three community-dwelling elderly with independent activities of daily living were recruited and randomly allocated into either PNF group - exercise in PNF pattern by trained physiotherapists or Theraband-PNF (T-PNF) group - exercise using theraband in PNF pattern, for an hour, twice weekly for 4 weeks. Functional outcomes such as Timed Up and Go test, Elderly Mobility Scale, Berg balance scale, functional reach and subjective measures including fear of fall (FOF) scale, bodily pain in visual analogue scale were measured pre and post-program. RESULTS: Twenty-one participants completed the program. PNF group demonstrated significant within-group improvements in all subjective measures and objective measures. Similar within-group improvements were demonstrated in all outcome measures except FOFS in T-PNF group. However, no between-group differences were found in any of the outcome measures. CONCLUSION: Comparable improvements in functional outcomes in community dwelling elderly were demonstrated in both groups. As manual PNF exercise traditionally need clinicians' contact and feedback on patient which limit the training to be carried out extensively in community setting. The current findings suggest that exercise using theraband in PNF pattern is feasible to be adopted as self-practice exercise for community-dwelling elderly to induce beneficial effects on functional outcomes.

• 대한물리의학회지
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• 제11권4호
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• pp.41-47
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• 2016

PURPOSE: The purpose of this study was to investigate the effects of differences in exercise time arrangement on the functional recovery of the lower limbs and balance of stroke patients. METHODS: The subjects of this study were 100 patients who were hospitalized in two hospitals located in Gyeonggi-do. Before the experiment, 60 of these patients who met the inclusion criteria and did not meet the exclusion criteria were randomly divided into an experimental group (n = 30), whose exercise time was concentrated, and a control group (n = 30), whose exercise time was diffuse. The two groups underwent six weeks of physical and occupational therapy four times a day for five days a week. One session of therapy took 30 minutes, including three sets of physical therapy and one set of occupational therapy. The rest time between the sessions was different for each group. The experimental group had five minutes of rest between each therapy session, and the control group had two hours of rest time between each session. The Fugl-Meyer assessment (FMA), an assessment of each patient's limit of stability (LOS), and a timed up and go test (TUG) were used as test tools. RESULTS: Both groups showed statistically significant increases in their FMA results, LOS measurements, and TUG results. The FMA results of the experimental group were significantly higher than those of the control group. CONCLUSION: Thus, concentrated exercise time was more effective than diffuse exercise time for the recovery of motor function.

• 대한물리치료과학회지
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• 제30권1호
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• pp.62-71
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• 2023

Background: This study was performed to evaluate the effects of Thermal stimulation combined virtual reality training (TV) on improvement of upper extremity AROM and function in patient with chronic stroke. Design: Two groups pre-post randomized controlled design. Methods: A single-blind, randomized controlled trial was conducted with 30 chronic stroke patients. They were randomly allocated two groups; the TV group (n=15) and Virtual Reality training group (VT) (n=15). The TV group received treatment for 30 min - 15 min of Thermal stimulation, and 15 min of VR training. The VT group received 15 min of VR training. Each group performed 30 minutes a day 3 times a week for 8 weeks. The primary outcome upper extremity AROM and function were measured by a active range of motion test, Manual Function Test (MFT) and Jebsen-Taylor hand function Test (JTT). The upper extremity active range of motion was evaluated using a digital dual inclinometer. MFT and JTT were used to evaluate the hand function. The measurement were performed before and after the 8 weeks intervention period. Results: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke. Conclusion: Both groups demonstrated significant improvement of outcome in muscle strength and upper extremity function during intervention period. TV group revealed significant differences in AROM and upper extremity function as compared to the VT groups (p<.05). Our results showed that TV was more effective on upper extremity AROM and function in patients with chronic stroke.

• Journal of Acupuncture Research
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• 제21권1호
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• pp.149-158
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• 2004

Objective: Herniation of Nucleus Pulpous(HNP) of L-spine is the most important reason that causes low back pain. The aim of this study is to investigate the effectiveness of Bee venom acua-acupuncture therapy for HNP. Methods: We divided HNP patient into 2 groups: Control group with acupuncture therapy only, and Experimental group with both acupuncture and bee venom acua-acupuncture therapy. To estimate the efficacy of treatment that applied for two groups, we used visual analog scale(VAS) and Oswestry disability index(ODI). We compared the VAS and ODI score of two groups statistically. Results & Conclusions: 1. In VAS, experimental group shows statitically significant improvement rate, but control group does not show statistical significance. 2. In ODI, both the experimental and control group shows statistically significant improvement. 3. By comparing the experimental and control group, there was more significant improvement in experimental group than control group of VAS and ODI. As a result, bee venom acua-acupuncture therapy can be used with acupuncture therapy for highly effective treatment for HNP.

• Journal of Acupuncture Research
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• 제35권4호
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• pp.193-199
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• 2018

Background: The purpose of this study was to investigate electric moxibustion on patients with back pain caused by road traffic accidents. Methods: This was a retrospective study (n = 112) comparing treatment with Korean medicine combined with electric moxibustion (n = 56), and Korean medicine alone (n = 56). Patient gender, age, Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EuroQol-5 Dimension (EQ-5D) was recorded for each group at the time of hospital admission. Mean NRS measured weekly, mean ODI and EQ-5D scores were measured 2 weeks post-treatment, and evaluated by paired sample t test. using the Statistical Program for Social Science v. 25.0 for Windows. An independent, two-sample t test was used to test for a significant difference in the decrement of NRS, ODI and increment EQ-5D scores between groups. Results: NRS scores decreased in both groups after 1 week of treatment (electric moxibustion, from $5.13{\pm}0.79$ to $3.86{\pm}0.67$; Korean medicine alone, from $5.18{\pm}0.92$ to $4.30{\pm}0.94$; both p < 0.001). There was a significantly greater reduction in NRS score in the electric moxibustion group ($1.27{\pm}0.59$) than in the Korean medicine alone group ($0.88{\pm}0.61$; p = 0.001). After 2 weeks of treatment, EQ-5D scores increased significantly in the moxibustion group ($0.19{\pm}0.12$) compared with the Korean medicine alone group ($0.13{\pm}0.20$; p = 0.043). After 2 weeks of treatment, NRS and ODI scores decreased in both groups. EQ-5D increased in both groups. Conclusion: We suggest that electric moxibustion treatment may be effective for reducing early-stage back pain in patients with road traffic accident injuries.

• 대한물리의학회지
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• 제7권4호
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• pp.481-491
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• 2012

PURPOSE: This study find out the effect of improved two point discrimination (TPD), hand function and activities of daily living (ADL) performance through tactile stimulus of upper limb (U/L) in impaired characteristics of stroke METHODS: We selected 26 stroke patients in BMH who has problems with neglect, sensory and motor deficits. Patients were divided into 3 group with neglect group (NG), sensorimotor deficits group (SMG) and motor deficit group (MG). To compare each group we used assessment tools such as two point discrimination on affected side (TPDas) and unaffected side (TPDus), Manual functional test on affected side (MFTas) and unaffected side (MFTus) and Korean version modified barthel index (K-MBI). RESULTS: 1) In the NG, tactile stimulus on U/L was statistically important for TPDas (forearm, index finger tip) also SMG and MDG was statistically important for TPDas. 2) In the NG, SMG, there was statistically important for MFTas, MFTus and in the MG. K-MBI also was statistically importance. Among three group, there was an statistically important difference for TPTus (forearm, thenar, hypothenar), MFTas and MFTus. We analyzed the relationship among TPD, MFT and K-MBI and There was negative relationship between TPD, MFT and There was positive relationship between TPD and K-MBI CONCLUSION: In impaired characteristics of stroke patients, tactile stimulus on U/L influenced on two point discrimination, hand function and ADL's. And we also found relationship among somatosensory, hand function, and ADL performance.

• 한방재활의학과학회지
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• 제31권4호
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• pp.49-63
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• 2021

Objectives This study aimed to investigate the trend in treating fracture with acupuncture and to evaluate the quality of case reports. Methods All case reports of fractures treated with acupuncture were extracted from four Korean web databases. We classified these studies by five fracture sites and investigated frequently used meridian and acupoint, outcome measurements, treatment period. And we assessed the quality of the case reports by the STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines. Results A total of 33 case reports were included. The outcome measurements were divided into six categories, and the outcome measurements used in more than three studies showed improvement in patient symptoms. The mainly used meridians for each fracture site were as follows: chest and abdomen (GB, LR, CV), back (BL, GB), upper limb (LI, TE), lower Limb (GB, ST, BL, SP). The most commonly used acupoints for each fracture site were as follows: chest and abdomen (Ashi points, GB24, GB25, GB26, LR13, LR14, CV16, CV17, CV18, CV19), back (BL23, BL24, BL25, BL26, BL40, BL51, BL52, BL60, GB34), upper limb (LI4, LI10, LI11, TE3), lower limb (GB34, GB40). According to the STRICTA guidelines, more than 54.54% of the reports were found to be 'not reported' or 'not sufficient' in the following categories: 'response sought', 'description of participating acupuncturist', and 'number of needle insertions per subject per session'. Conclusions The meridians and acupuncture points frequently used for acupuncture treatment of fractures were near the fracture site. Future clinical studies involving acupuncture must be reported in accordance with the STRICTA guidelines to improve transparency and uniformity.

• 대한물리의학회지
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• 제11권1호
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• pp.133-140
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• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.