• Journal of Korean Academy of Nursing
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• v.34 no.8
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• pp.1451-1459
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• 2004

Purpose. With a sample of cognitively impaired nursing home residents and nursing staff, the following were examined 1) the proportion and nature of aggressive behavior, 2) the frequency and types of aggressive behavior, 3) the difference between the residents who demonstrate aggressive behavior and those who do not demonstrate aggressive behavior (age, mental status, functional status, and pain, length of nursing home stay), and 4) nursing staff responses to aggressive behavior by residents. Methods. A cross-sectional descriptive study design was used. Data were collected from cognitively impaired nursing home residents (N=205) and nursing staff (N=60) at two nursing homes using Ryden Aggression Scale I and II, Mini-Mental State Exam, Modified Barthel Index, Verbal Descriptor Scale, and aggressive behavior management questionnaire. Data were analyzed using descriptive statistics including t-test. Results. About $62.9\%$ residents were found to be aggressive and $38.5\%$ were both physically and verbally aggressive. Pushing, making threatening gestures, hitting, slapping, cursing/obscene/vulgar languages, making verbal threats were occurred frequently. Aggressive residents were significantly older, had more cognitive impairment, had more pain, and stayed longer in the nursing home when compared with non-aggressive residents. Considerable proportion of nursing staff responded to aggressive behaviors inadequately. Conclusion. Aggressive behavior among cognitively impaired nursing home residents is prevalent thus needs to be prevented and reduced. Along with environmental modification, educational programs for nursing staff and family caregivers need to be developed and implemented so that they can have extensive knowledge and skills to manage aggressive behaviors.

• Physical Therapy Rehabilitation Science
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• v.8 no.4
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• pp.187-193
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• 2019

Objective: The aim of this preliminary study was to investigate the effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living (ADL) in persons with acute stroke. Design: Randomized controlled trial. Methods: Fourteen acute stroke survivors were recruited and randomly assigned into two groups: the experimental group (n=7) and the control group (n=7). Both groups performed the conventional rehabilitation therapy for 30 minutes a day, 5 times a week, for 4 weeks. Additionally, the experimental group conducted the virtual reality training for 30 minutes on an unstable surface during each session, whereas the control group performed balance training for 30 minutes on a stable surface. All measurements were performed before and one day after intervention. Upper limb function, balance, and ADL were assessed using the Manual Function Test (MFT), the Berg Balance Scale (BBS), and the Korean version of the Modified Barthel Index (K-MBI), respectively. Results: Both groups showed significant improvements in MFT, BBS, K-MBI after intervention (p<0.05). There were no significant differences between the experimental and control groups with respect to MFT, BBS, and K-MBI after intervention. The experimental group showed a greater decrease in fall risk (BBS<45) after intervention than the control group (p<0.05). Conclusions: These findings suggest that virtual reality combined with balance training has a better effect on balance improvement than virtual reality training alone in persons with acute stroke.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.55-64
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• 2016

PURPOSE: The aim of this study was to examine the effect of air stacking exercise on lung capacity, activities of daily living, and walking ability in elderly adults. METHODS: A total of 27 subjects were randomly assigned to an experimental group (EG=13) or a control group (CG=14). Subjects in the experimental group participated in an active pulmonary rehabilitation program. 5 days a week for 4 weeks. The active pulmonary rehabilitation program was composed of an air stacking exercise with an oral nasal mask and manually assisted coughing. Conventional pulmonary rehabilitation exercises, such as, cough exercise, deep breathing, and abdominal muscle strengthening exercises were performed by both groups. Pulmonary function parameters, peak cough flow (PCF), and oxygen saturation were measured and the 6-minute walk test and Korean version of the modified Barthel index (K-MBI) scores were applied. RESULTS: Significant intergroup differences were observed for forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) results after intervention (p<.05), and for 6 minute walk test and PCF results after intervention and at 2-week follow-up visits (p<.05). Post hoc test results showed significant differences in K-MBI, 6-minute walk test, and FEV1 in the experimental group after intervention (p<.05). FVC values were significantly higher after intervention and at 2-week follow-up visits versus pre-intervention (p<.05). PCF values were also significantly higher after intervention and remained significantly higher at 2-week follow-up visits (p<.05). CONCLUSION: Air stacking exercise in elderly adults improves lung capacity and exercise tolerance.

• Physical Therapy Korea
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• v.17 no.2
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• pp.33-42
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• 2010

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.29-42
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• 2019

Objectives : This study aimed to review the effects of Daoyin exercise on stroke patients in clinical studies. Methods : In this study, we reviewed 11 electronic databases (CAJ, EMBASE, Cochrane Library, Web of Science, Pubmed, RISS, Dbpia, NDSL, KISTI, KISS, KMBASE) on October 27, 2019. We included only randomized controlled trials (RCTs) which evaluated the effect of Daoyin exercise on stroke patients. The methodological quality of the included studies was checked using the Cochrane risk of bias tool. Results : After screening the papers, eleven RCTs fulfilled the inclusion criteria. The results of the meta-analysis showed that Daoyin exercise improves the measurement value on the Fugl-Meyer Assessment, Modified Barthel Index and National Institutes of Health Stroke Scale in stroke patients. Conclusions : We concluded that Daoyin exercise has therapeutic effects in functional recovery and in enhancing the independence of daily living activities for stroke patients. However, the quality of the original articles was low and the number of papers included were few. Thus, to confirm these results, further well-designed RCTs should be conducted.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.15-28
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• 2019

Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.

• Korean Journal of Adult Nursing
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• v.28 no.6
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• pp.637-645
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• 2016

Purpose: The purpose of this study was to identify the occurrences and the factors contributing to constipation in the post surgical period following major orthopedic surgery. Methods: The sample included 133 patients who had surgery of the hip, knee, or spine. Patients were excluded from the study if there was a history of bowel surgery or constipation from chart review. Data were collected using questionnaires such as Korean version of Modified Barthel index (K-MBI), Hospital Anxiety and Depression Scale, and Constipation Assessment Scale (CAS) before surgery and on the third postoperative day. Results: Reports of constipation occurred in 77 instances (57.9%). The first reported defecation was within $4.0{\pm}2.2days$ following surgery. Mean days of first defecation of constipation group vs. non-constipation group was $5.5{\pm}1.7days$ vs. $2.1{\pm}1.0days$. There were statistically significant differences between patients who reported than those who did not in terms of age, length of NPO period, postoperative ADL, and the reported incidents of preoperative and postoperative depressive symptoms. Postoperative ADL, age, and NPO period were significant influencing factors of constipation and explained 52.4% of the variance. Conclusion: Constipation is a very common symptom for patients undergoing orthopedic surgery. These results indicate a need for improving patient's ADL after surgery to prevent constipation.

• The Journal of Korean Medicine
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• v.23 no.2
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• pp.180-189
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• 2002

Background and Purpose : The hemiplegic upper extremity is affected in many stroke patients, and recovery is often poor. The purpose of this study was to assess the efficacy of electroacupuncture (EA) in enhancing the upper extremity motor and functional recovery of ischemic stroke patients. Subjects and Methods : Forty ischemic stroke patients (the upper extremity Fugl-Meyer motor scale (FM) score lower than 46, lesion location within middle cerebral artery territory) within 2 weeks of stroke onset were randomly allocated to either an EA group that received EA treatment or a control group that received only routine ward care. The EA was applied at Quchi-Shousanli (LI11-LI10), Waiguan-Hegu (TE5-LI4) points on the hemiparetic side six times per week for 4 weeks. The frequency of stimulation was 25-50Hz and the intensity was set at a level sufficient to induce muscle contraction. EA treatment was given for 30 minutes and all patients of both groups received standard rehabilitation program. Outcomes were assessed, in a blind manner, before treatment began and at 4 weeks after treatment, with the FM, the Motor Power score (MP) for shoulder/elbow, and the subsection of the Modified Barthel Index (MBI) for drinking/feeding/dressing upper body/grooming. Results : These 2 groups had comparable clinical characteristics, lesion location, lesion size, and pretreatment impairment scores. By the end of treatment, the EA group showed significantly more improvement than the control group in the subsection of the FM for shoulder/elbow/coordination (6.4 vs. 3.7; P=0.047) and the MP for shoulder/elbow (5.3 vs. 3.3; P=0.008). The subsection scores of the MBI for drinking/feeding/dressing upper body/grooming were not significantly different between two groups. No adverse effects due to treatment were found Conclusion : These results suggest that EA enhances the upper extremity motor recovery of acute stroke patients. However, this study failed to demonstrate any significant functional benefit related with upper extremity. Future study should be carried out in a larger sample size and use the functional outcome measure that is more specific and sensitive to the upper extremity.

• The Korean Journal of Rehabilitation Nursing
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• v.13 no.1
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• pp.23-31
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• 2010

Purpose: The purpose of this study were to describe the level of activities of daily living (ADLs) and fatigue of stroke patients and to identify related factors of ADLs and fatigue. Method: A sample of 132 were used who were recovering from stroke. The face-to-face interviews were conducted to collect data. The levels of ADLs and fatigue were evaluated using the Modified Barthel Index and Kim's fatigue scale respectively. A series of t-test and analysis of variance analyses were conducted to examine study purposes using SPSS 15.0. Results: The levels of fatigue and ADLs were 65.6 (SD=16.52) and 74.6 (SD=22.32) respectively. Significantly poorer ADLs were found: women (t=2.05, p=.001), older people aged ${\geq}$ 70 years (F=2.74, p=.046), the duration of onset (F=4.34, p=.006), the use of assist devices (F=35.64, p<.001), the parts of paralysis (F=4.25, p=.007), the time to attack (F=3.34, p=.039), and accompanying symptoms (F=15.23, p<.001). There was a significant difference in fatigue with patients with lower accompanying symptoms having lower fatigue (F=11.08, p<.001). Conclusion: These findings suggest gender, the duration from onset, the use of assist device, the parts of paralysis, the time to attack and accompanying symptoms were significant factors of the ADLs and fatigue post stroke. These factors should be considered when developing and testing nursing intervention programs for stroke survivors.

• The Journal of Internal Korean Medicine
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• v.39 no.5
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• pp.1015-1022
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• 2018

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. Methods: The patient was treated with herbal medicine (Gamicheongsim-tang, Hwangryunhaedok-tang-tablet), acupuncture, moxibustion, and rehabilitative therapy. The effects of these treatments were evaluated using the manual muscle test (MMT), sensory scale, Korean version of the modified Barthel index (K-MBI), and the National Institutes of Health Stroke Scale (NIHSS). Results: After treatment, the MMT grade improved from 3+/3+ to 4+/4+, and the sensory scale increased from 40%/40%/40% to 80%/80%/80%. In addition, the K-MBI score improved from 56 to 100, and the NIHSS score decreased from 7 to 1. Conclusion: The results suggest that traditional Korean medicine can be effective in the treatment of patients with ICH.