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The Effects of Virtual Reality Training on Improving Hand Function and Activities of Daily Living in Patients Living Post-Stroke: A Pilot Study (뇌졸중 후 환자의 일상생활활동 및 손 기능 개선에 대한 가상현실 훈련의 효과 : 예비 연구)

  • Moon, Jong-Hoon;Jeon, Min-Jae
    • Journal of Digital Convergence
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    • v.17 no.11
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    • pp.349-355
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    • 2019
  • The virtual reality training has been suggested as an intervention to improve physical function. But, the effects of virtual reality training focused on improving ADL in patients with acute stroke are unclear. Purpose of this study was to examine the effect of virtual reality training on hand function and activities of daily living (ADL) in patients with acute stroke. Sixteen patients with acute stroke were included in this study. The experimental group (VRA group) received 30 minutes of virtual reality training focused on ADL for each session, while the control group received 30 minutes of conventional virtual reality training. To examine the hand function and ADL of the subjects, the study used Jebsen-Tylor Hand Function Test (JTHFT) and Korean Modified Barthel Index (K-MBI), respectively. Both groups showed significant improvements in hand function of affected and unaffected sides, and in K-MBI total score before and after the intervention. The experimental group showed significantly greater improvements in the self-care domain of K-MBI after intervention than the control group. These findings suggest that the virtual reality training focused on ADL may have a better effect on self-care than conventional virtual reality training in patients with acute stroke.

Kinetic Studies on Homopolymerization of $\alpha$-Methylstyrene and Sequential Block Copolymerization of Isobutylene with $\alpha$-Methylstyrene by Living/Controlled Cationic Polymerization (리빙/조절 양이온중합에 의한 알파메틸스티렌 호모중합 및 이소부틸렌과의 블록공중합에 대한 반응속도론 연구)

  • Wu, Yibo;Guo, Wenli;Li, Shuxin;Gong, Huiqing
    • Polymer(Korea)
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    • v.32 no.4
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    • pp.366-371
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    • 2008
  • The controlled/living cationic polymerization of $\alpha$-methylstyrene (${\alpha}MeSt$) and sequential block copolymerization of isobutylene (IB) with ${\alpha}MeSt$ were achieved using 2-chloro-2,4,4-trimethylpentane (TMPCl)/titanium tetrachloride ($TiCl_4$)/titanium isopropoxide ($Ti(OiPr)_4$)/2,6-ditert-butylpyridine (DtBP) initiating system in $CH_3Cl$/hexane(50/50 v/v) solvent mixture at $-80^{\circ}C$. The polymerization rate decreased with increasing $[Ti(OiPr)_4]/[TiCl_4]$ ratio in the homopolymerization of ${\alpha}MeSt$. The effects of $[Ti(OiPr)_4]/[TiCl_4]$ ratios and $PIB^+$ molecular weight on the polymerization rate and blocking efficiency were also investigated. Well-defined poly(isobutylene-b-$\alpha$-methylstyrene)s were demonstrated by $^1H$-NMR and triple detection SEC; refractive index (RI), multiangle laser light scattering (MALLS) and ultraviolet (UV) detectors. Blocking efficiencies for the poly(isobutylene-b-$\alpha$-methylstyrene)s of almost 100% were obtained when ${\alpha}MeSt$ was induced by PIB's of $M_n\;{\geq}\;41000$ at $[Ti(OiPr)_4]/[TiCl_4]=1$. Differential scanning calorimetry (DSC) of the block copolymers showed two glass transition temperatures, thereby demonstrating microphase separation.

The Shoulder Pain after Stroke and the relationship with Motor Function, and Quality of Life (뇌졸중 환자의 견관절 통증과 운동 기능 및 삶의 만족도와의 관계)

  • Lee, Dong-Jin;An, Seung-Heon
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.3
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    • pp.257-266
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    • 2011
  • Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

The Cost of Long-Term Care Alternatives for the Elderly (미국 노인환자들의 만성질환관리형태에 대한 비용분석)

  • Lee, Tae-Wha
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.351-361
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    • 1998
  • The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

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The Effects of Mirror Therapy with Functional Electrical Stimulation Therapy on Upper Extremity Motor Function and Activities of Daily Living for the Stroke Patients (뇌졸중 환자에 대한 기능적 전기 자극치료를 병행한 거울치료가 상지 기능수행과 일상생활활동에 미치는 효과)

  • Lee, Minjae;Koo, Hyunmo
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.3
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    • pp.123-130
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    • 2018
  • Purpose : The purpose of this study was to investigate the effects of mirror therapy with functional electrical stimulation to improve upper extremity motor function and activities of daily living (ADL) in stroke patients. Method : Thirty patients were randomly assigned to the experimental and control groups 15 patients in each. All subjects received the general occupational therapy consisting of five 30 min sessions per week for 8 weeks, in addition to 30 min of mirror therapy with functional electrical stimulation for the experimental group and 30 min of functional electrical stimulation for the control group for each session. To measure the functions of the upper limb and performance capacities in ADL, the Fugl-Meyer Assessment (FMA), and Manual Function Test (MFT), Modified Barthel Index (MBI) were used before and after the interventions. Results : Both the experimental and control groups showed a statistically significant increase in post-treatment FMA, MFT and MBI scores compared to their pre-treatment scores (p<.05). In addition, intergroup comparisons revealed a statistically significant increase in the scores of all assessments for the experimental group compared to those for the control group (p<.05). Conclusion : Based on these results, it is reasonable to conclude that mirror therapy with functional electrical stimulation is an effective intervention for improving upper limb motor function and ADL performance in stroke patients.

Comparison of Self-living Ability, Obesity Indices and Nutrient Intake according to Physical Fitness among the Elderly in Rural Areas (농촌 지역 일부 노인에서 신체 기능 정도에 따른 활동 제한도, 비만도 및 영양소 섭취 수준의 변화 양상 비교)

  • Suh, Hee-Jae;Kim, Bok-Hee
    • The Korean Journal of Food And Nutrition
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    • v.22 no.4
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    • pp.577-586
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    • 2009
  • Aging is associated with decreased energy expenditure, thermogenesis and energy requirements. Maintenance of physical fitness of the elderly has been reported to reduce the rate at which the basal metabolic rate, muscle strength, skeletal muscle mass and bone density deteriorate. Skeletal muscle disease is known to increase the risk of physical disability and psychological problems. This study was conducted to investigate changes in disability, emotional problems, body compositions, obesity indices and nutrient intake levels according to physical fitness with the elderly in rural areas. According to the results, physical fitness was negatively related with Activities of Daily Living(ADL, p<0.05), Instrumental Activities of Daily Living(IADL, p<0.001), Body Mass Index(BMI, p<0.001) and abdominal obesity(p<0.05), while it showed a positive correlation with the General Self Efficacy Scale(GSES)(p<0.001) and nutrient intake(p<0.05). When changes in these factors were compared according to the range of quartile of the Fullerton Advanced Balance Scale(FAB Scale), GSES(Q1=35.3, Q2=43.5, Q3=53.2, Q4=51.9, p<0.001), BMI(Q1=36.1%, Q2=34.7%, Q3=33.2%, Q4=28.6%, p<0.01), abdominal obesity(Q1=1.02, Q2=0.99, Q3=0.97, Q4=0.94, p<0.001) and nutrient intake(Q1=71.1%, Q2=75.4%, Q3=80.6%, Q4=80.2%, p<0.05) differed significantly. Taken together, these results suggested that better physical fitness would lead to a reduction in negative factors including physical disability and obesity indices, but to an increase in positive factors such as GSES and nutrient intake. The results of this study are expected to be used as basic data for the development of programs to promote the health of the elderly in a local society.

Assessment of Dietary Intake Obtained by 24 -hour Recall Method in Adults Living in Yeonchon Area(1) ; Assessment Based on Nutrient Intake (24시간 회상법으로 조사한 연천지역 성인의 식생활 평가(1) : 영양소 섭취평가)

  • 이심열
    • Journal of Nutrition and Health
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    • v.31 no.3
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    • pp.333-342
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    • 1998
  • To assess the nutrient intake and diet quality of Korean adults living in rural area, dietary survey with one day 24 -hour recall method was given to 2037 subjects over 30 years of age living in Yeoncho-gun, Kyungki province of Korea, together with health survey. The mean daily energy intake was 1583 kcal, with 65.4% of energy intake being supplied by carbohydrate, 15.9% by protein and 18.7% by fat. Eighty percents of total food intake were supplied by vegetable food and the rest in the form of animal food . As well as insufficiencies in calcium and iron intake, the bioabailability of calcium and iron is considered to have been low because most of those intakes came form plant origins. For most nutrients except phosporous, proportions of subjects with intake levels less than 75% of RDA was over 40% and highest in the elderly. Those proportion of low intake among female were higher than those among male. The mean adequacy ration(MAR) , an index of overall dietary quality was 0.62 for females and 0.68 for males and decreased with increase of age. The indexes of nutritional quality (INQ) were over 1 for most nutrients except 0.06 of vitamin A, 0.73 of calcium and 0.85 of vitamin C, Nutrient intake levels less than 75% of RDA may be appropriate as a criteria for insufficiency of nutrient intake. Based on these results, it is evident that some of adults in rural areas did not consume enough nutrients, especially vitamin A, calcium and vitamin B$_2$, and that the dietary intake of female and the elderly was not adequate .

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Lifestyles Effects on Stroke Risk in Different Regions in Korea (재가 여자 노인의 비만, 식이습관, 신체활동 정도에 관한 조사 연구-뇌졸중 예방과 관련하여)

  • 최스미;전미양;김은경
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.729-738
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    • 1998
  • Background and purpose : Stroke is a leading cause of death in Korea. Early measures to prevent stroke are extremely important since it has no cure. Korean might have different risk factors since their dietary habits and socio-economical status differ from most western countries. However, the risk factors for stroke in Korea have not yet been identified. Moreover, the lifestyle of healthy Korean adults has not been investigated. In this study we investigate the lifestyle of healthy adults living in Seoul and rural areas and compare the lifestyles of the two. Methods : One hundred seventy one subjects were studied. Among the subjects studied, 128 were from Seoul, the other 43 were from the country area. The age of the subjects was limited to over 40 years. Blood pressure, fast blood sugar, and cholesterol were measured. The subjects' height, weight, body mass index, total body fat, skinfolds thickness of triceps, subscapular and abdomen were measured to determine obesity. Using a structured interview, we assessed : sodium intake, physical activity and exercise, consumption of vegetables, fat, fish and fruits. The results of the two groups were compared. Results : There were no statistical differences in age and education between the two groups of subjects. The mean age of the subjects were 66 years old. The subjects residing in rural areas had a higher intake of sodium(p<0.05), lower physical activity(P<0.05), and higher BMI and body fat (p<0.05) as compared to the subjects in Seoul. Subjects with hypertension were between 24% and 33% and the prevalence of hypertension was the highest when compared to the prevalence of DM or hypercholesterolemia. However, the prevalence of hypertension, DM, hypercholesterolemia, were not significantly different in these areas. Conclusion : Our results show that subjects living in rural areas eat more salty food, exercise less, and tend to be obese. The finding of this study lead to speculation that Korean living in rural areas have less information about the effects of diet on health than city dwellers do. General health and nutrition education programs aimed at the prevention of stroke and other such conditions for rural area Koreans may close the risk factor gap between rural and urban dwellers.

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Relationships among Pain, Depression, Health behavior, and Activities of Daily Living in Older Adults after Femur Fracture Surgery (대퇴골절 수술을 받은 노인의 통증, 우울, 건강행위와 일상생활수행능력의 관계)

  • Shin, Soon Sik;Eun, Young
    • Journal of muscle and joint health
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    • v.22 no.1
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    • pp.1-12
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    • 2015
  • Purpose: The purpose of this study was to explore the relationships among pain, depression, health behaviors, and activities of daily living (ADL) in older adults after femur fracture surgery. Methods: This was a descriptive correlational study. Ninety seven outpatients aged 65 or older were selected, who agreed to participate and visited the four hospitals located in G providence. Numeric Rating Scale (NRS) for pain, a Short form Geriatric Depression Scale (SGDS) for depression, health behavior scale and Korean version of Bathel Index for ADL were used. Data were analyzed using t-test and ANOVA, Pearson's correlation and the hierarchical regression analysis in SPSS 18. Results: Pain and depression were positively correlated (r=.35, p<.001). Pain and health behaviors (r=-.30, p=.010), pain and ADL (r=-.21, p=.044), depression and health behaviors (r=-.51, p<.001), depression and ADL (r=-.29, p=.004) were negatively correlated. The variables affecting the ADL was intake of a painkiller or not (${\beta}$=-.32), age (${\beta}$=-.25), transitional period after discharge (${\beta}$=.23) and depression (${\beta}$=-.23). ADL was accounted for 33.4% in total by these four variables. Conclusion: Interventions for alleviating pain, and managing depression would be effective in enhancing ADL in older adults after femur fracture surgery.

Species Composition of Fish from Sea Grass Bed in Chuuk Lagoon, Micronesia (마이크로네시아 축 환초내 잘피밭의 어류 종조성)

  • Choi, Young-Ung;Yoon, Kon-Tak;Lee, Dae-Won;Kim, Taihun;Kim, Yoonchil;Park, Heung-Sik
    • Ocean and Polar Research
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    • v.35 no.4
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    • pp.441-452
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    • 2013
  • The fish species composition of seagrass bed in Chuuk Lagoon, Micronesia, was investigated every month from August 2009 to July 2011, using a seine net for fish caught. A total of 32 fish species belonging to 18 families under 6 orders were identified during the study period. Of these fish, Atherinomrus lacunosus, and Strongylura incise were the major dominant species representing 85.0% in total number of individuals. The number of species and individuals were high from August to December 2009, 2010. The biomass was highest in September 2010 and the diversity index was higher in September 2009, April, August 2010 and July 2011. The 14 dominant species could be divided into 2 groups of 3 individuals based on appearance patterns; (1) resident species and temporal species (9 species, e.g. Atherinomrus lacunosus), juvenile and adults living in seagrass beds and juveniles living only in seagrass beds; (2) temporal species (2 species, e.g. Hemiramphus lutkei), juveniles living only in seagrass beds; (3) temporal species (3 individuals, e.g. Caranx sexfasiatus). For some species, the appearance patterns were affected by water temperature. However, the relationships between sea currents, salinity, tide, and structure of fish assemblage remain unclear. Further studies that regularly monitor sea grass habitats are necessary to clearly understand the correlation between environmental factors and sea grass habitat use patterns in fish assemblages.