• 대한한방내과학회지
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• 제38권2호
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• pp.180-189
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• 2017

Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with an intracerebral hemorrhage (ICH) at the left basal ganglia, thalamus, and posterior limb of the internal capsule. Methods: The patient was treated with acupuncture, moxibustion, Hyangsayukgunja-tang, and Samul-tang-gami. The effect of these treatments were evaluated using the manual muscle test (MMT), modified Barthel index (MBI), and National Institutes of Health Stroke Scale (NIHSS). Results: After the treatments, the patient's status improved, as shown by his MMT grade, which increased from 1/1 to 4/4. In addition, the patient's MBI score improved from 0 to 77, and his NIHSS score declined from 16 to 2. In addition, the patient's Levin tube and Foley catheter were removed. Conclusion: The results suggest that traditional Korean medicine may be effective in the treatment of patients with ICH.

• 대한통합의학회지
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• 제6권3호
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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.

• 대한한방내과학회지
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• 제41권5호
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• pp.777-786
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• 2020

Background: This study is a report on a case of a Wernicke's encephalopathy with quadriplegia, ataxia, and impaired cognition, whose condition was improved by Korean medicine treatment. Case report: A 51-year-old man diagnosed with Wernicke's encephalopathy was treated with acupuncture, Banhabakchulchunma-tang mixed with Ondam-tang-gami (半夏白朮天麻湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Berg Balance Scale (BBS), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), Modified Barthel Index (MBI), and a numeric rating scale (NRS). After 22 days of treatment, his clinical symptoms showed improvement. The motor function improved (MMT Rt. side Gr. 4+G/4+G, Lt. side Gr. 4G/4+G → Rt. side Gr. 5-N/4+G, Lt. side Gr. 5-N/4+G), Ataxia was relieved (BBS 3→33), cognition improved (K-MMSE 15→27), ADL scores showed improvement (FIM 58→90, MBI 40→75), and the NRS score decreased for headache (3→0). Conclusion: Korean medicine treatment could be effective in the treatment of patients with Wernicke's encephalopathy.

• 대한물리의학회지
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• 제11권2호
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• pp.83-91
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• 2016

PURPOSE: The purpose of this study was to determine the efficacy of dual-task action observation training (AOT) and single-task AOT related with daily living task on walking ability and ADL performance in chronic stroke patients. METHODS: Twenty-seven chronic stroke subjects were included in the study. They were randomly assigned to three task categorieds as follows: whole dual-task AOT or partial dual-task AOT or single-task AOT rehabilitation. Whole dual-task AOT observed the movement at once and partial dual-task AOT observed the movement divided into 4 parts related functional gait and activities of daily living task for 2 minutes 30 seconds. Single-task AOT observed the movement related functional gait for 2 minutes 30 seconds. Both groups had physical training session for 12 minutes 30 seconds. The study was conducted for four weeks, with three training sessions a week, for twelve weeks. All subjects were evaluated for their walking ability and activities of daily living through devices, 10m walking test (10MWT), dynamic gait index (DGI), and Korea-Modified Barthel Index (K-MBI). RESULTS: A significant improvement of walking ability and ADL performance happened among dual-task AOT subjects, compared with a single-task AOT subjects, during the 4-weeks course treatment. The results of the study showed statistically significant differences in 10MWT (p<0.05) and DGI (p<0.05), and K-MBI (p<0.05). CONCLUSION: Our results indicated that dual-task AOT has a positive additional impact on recovery of walking ability and ADL performance in chronic stroke patients.

• Journal of Preventive Medicine and Public Health
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• 제28권3호
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• pp.563-575
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• 1995

In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBI(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and Chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBI data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality, duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.

• 한국산학기술학회논문지
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• 제14권8호
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• pp.3739-3747
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• 2013

본 연구는 상사-부하관계가 사회복지시설의 종사자인 사회복지사의 소진과 경력변경의도에 미치는 영향을 살펴본 것으로, 민간 사회복지시설의 사회복지사 342명의 구조화된 설문자료를 분석하였다. 이를 위해 소진은 정서적 고갈(EE), 비인간화(DP), 성취감 감소(PA)로 구성된 Maslach와 Jackson의 MBI를 사용하였다. 구조방정식을 이용한 연구 결과, 사회복지사들이 인식한 LMX 수준은 5점 척도의 평균값 이상으로 나타났다. 또한 LMX는 소진과 경력변경 의도에 부(-)적 영향을 미치고, 특히 소진의 구성요소 중 정서적 고갈과 비인간화는 경력변경의도에 정(+)의 영향을 미치는 것으로 나타났다. 이러한 결과를 바탕으로 사회복지조직에서 활용할 수 있는 LMX 전략에 관한 실천적 함의를 논의하였다.

• 한국콘텐츠학회논문지
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• 제20권9호
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• pp.531-540
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• 2020

본 연구의 목적은 4주 동안 모니터기반 가상현실게임 중재가 급성기 뇌졸중 환자의 인지 기능과 일상생활활동에 미치는 영향에 대해 알아보기 위함이었다. 본 연구는 급성기 뇌졸중 환자 19명이 참여하였다. 모니터기반 가상현실 게임중재와 전산화 인지중재의 효과성을 비교하기 위하여, 두 집단에 1일 30분, 주 5회, 총 4주 중재하였고, 효과에 대한 측정은 TMT A & B, DST, RKMT, K-MBI를 중재 전과 후에 실시하였다. 실험군에서는 모든 변수에 대해 유의미한 향상을 보였으나, 대조군에서는 TMT A와 DST을 제외한 항목에서만 유의미한 향상을 보였다. 본 연구를 통하여, 가상현실게임 중재가 뇌졸중 환자의 인지 기능과 일상생활활동에 효과적인 치료로 적용될 가능성을 확인하였다. 또한 모니터기반 가상현실게임 중재가 인지중재를 필요로 하는 환자들에게 임상에 있는 작업치료사들이 유용하게 사용될 수 있을 것이라 사료된다.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.293-298
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• 2011

Objective : The extracellular matrix (ECM) and cell adhesion molecules play crucial roles in angiogenesis, apoptosis, thrombosis, and inflammation, and also contribute to the pathogenesis of stroke. Integrin, alpha 6 (ITGA6) is a member of ECM adhesion receptors. We investigated whether two single nucleotide polymorphisms (SNPs) (rs11895564, Ala380Thr; rs2293649, Asp694Asp) of ITGA6 were associated with the development and clinical phenotypes of intracerebral hemorrhage (ICH) and ischemic stroke (IS). Methods : We enrolled 199 stroke (78 ICH and 121 IS) and 291 control subjects. Stroke patients were divided into subgroups according to the scores of the National Institutes of Health Stroke Survey (NIHSS, <6 and ${\geq}6$) and Modified Barthel Index (MBI, <60 and ${\geq}60$). SNPStats, SNPAnalyzer, and Helixtree programs were used to calculate odds ratios, 95% confidence intervals, and p values. Multiple logistic regression models were used to analyze genetic data. Results : A missense SNP rs11895564 was associated with the development of ICH (p=0.026 in codominant2, p=0.013 in recessive, p=0.02 in log-additive models; p=0.041 in allele distributions). The A allele frequency of rs11895564 was higher in the ICH group (13.5%) than in the control group (8.1%). In the clinical phenotypes, rs11895564 and rs2293649 showed significant associations in the MBI scores of IS (p=0.014 in codominant1 model; p=0.02 in allele distributions) and NIHSS scores of ICH (p=0.017 in codominant2, p=0.035 in recessive, p=0.035 in log-additive models), respectively. Conclusion : These results suggest that ITGA6 may be associated with the development and clinical phenotypes of stroke in Korean population.

• 대한한방내과학회지
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• 제37권5호
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• pp.733-740
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• 2016

Objective: To evaluate the effects of integrative treatment with conventional and Korean medicine on cerebral infarction due to presumed paradoxical embolism through a patent foramen ovale. Methods: We applied acupuncture, herbal medication, western medication, and physical therapy routinely every day and applied fluid therapy provided as needed. The NIHSS, K-MBI, MRS, MMT, and MMSE-K score were determined to assess any improvement in symptoms. Results: Scores appeared to be improved for the NIHSS (9 to 5), K-MBI (94 to 100), MRS (2 to 1), MMT (2+, 4 to 4, 4), MMSE-K (24 to 26). No side effects were observed during the treatment. Conclusions: This study demonstrates that integrative treatment with conventional and Korean medicine may be an effective option for treating cerebral infarction due to a presumed paradoxical embolism through a patent foramen ovale.

• 대한물리의학회지
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• 제11권4호
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• pp.105-114
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• 2016

PURPOSE: This study is to investigate the therapeutic effect of Tetrax on balance dysfunction caused by ataxia in cerebellar stroke. METHODS: A total of thirty subjects with cerebellar stroke were recruited. The participants was divided into two groups, the experimental (n=15) and the control group (n=15). Tetrax training and conventional physical therapy (CPT) were performed in experimental group, whereas the patients in the control group were treated with CPT twice a day. Each session of the Tetrax and CPT was carried out for 30 minutes, 5 times per week for 4 weeks. Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) was the primary outcome measure, and the secondary outcomes covered Berg balance scale (BBS), falling index (FI), Timed up and go (TUG), and modified Barthel index of Korean version (K-MBI). All outcome measures were evaluated before and after 4 weeks. RESULTS: K-SARA was decreased significantly after 4 weeks intervention in both the experimental (p<.05) and the control group (p<.05). Furthermore, the experimental group produced significantly better outcomes in K-SARA, BBS, FI, and TUG compared with the control group (p=.012, p=.027, p=.008, and p=.048). There were significant correlations between K-SARA and BBS, FI, TUG, and K-MBI (p<.001, p<.001, p=.004, and p<.001). CONCLUSION: The restoration of ataxia was related with the improvement of the balance, falling risk, mobility, and activity of daily living. Tetrax training was effectively aided recovery of ataxia after cerebellar stroke.