• Title/Summary/Keyword: Musculoskeletal Injury

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Rehabilitation of spinal muscular atrophy: current consensus and future direction

  • Yi, You Gyoung;Shin, Hyung-Ik;Jang, Dae-Hyun
    • Journal of Genetic Medicine
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    • v.17 no.2
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    • pp.55-61
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    • 2020
  • Spinal muscular atrophy (SMA) is a neuromuscular disease that requires multidisciplinary medical care, including rehabilitation management. The emergence of a genetic therapy-based approach for SMA has markedly changed the disease course. Nonetheless, currently, updated physical therapy and rehabilitation are warranted for individuals with SMA in the era of gene therapy. In this review, we discuss the physical therapy and rehabilitation strategies currently performed for people with SMA, such as positioning and bracing, supported standing, management of musculoskeletal deformities, stretching, physical exercise training like aerobics and strengthening exercises, assistive devices, pulmonary rehabilitation, and dysphagia treatment.

A Study on Major Curriculum Based on Individual's Capacities-Focused on Physical Therapy Department in U University

  • Myoung-Hee Lee
    • The Journal of Korean Physical Therapy
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    • v.36 no.1
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    • pp.45-51
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    • 2024
  • Purpose: Since core competence-based training is in demand, this study aimed to develop a suitable talent model and major competencies for the Department of Physical Therapy at U University and use it to propose appropriate educational subjects. Methods: This case study was conducted at U university in Gyeongju-si, Gyeongsangbuk-do. To study curricula based on major competence, related documents were analyzed, expert opinions were obtained, and a consumer survey was conducted. Results: U University assigns major competencies for each department, develops subjects accordingly, maps them, and constructs a competency matrix. The four major competencies of physical therapy were defined as musculoskeletal system, nervous system, cardiorespiratory system and sports injury, and physical management abilities. In order to realize these major competencies, U University added subjects to its curriculum. Conclusion: The results of internal and external environmental analysis should be more actively considered to enable changes in subjects at the departmental level. In addition, the setting of major competencies should be subjected to more detailed, specific reviews to maintain the basic principles of major curricula.

Analysis of stair walking characteristics for the development of exoskeletal walking assist robot (외골격 보행보조로봇 개발을 위한 정상인의 계단보행특성 분석)

  • Cho, H.S.;Chang, Y.H.;Ryu, J.C.;Mun, M.S.;Kim, C.B.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.6 no.2
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    • pp.15-22
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    • 2012
  • The mechanical system of wearable walking assist robot needs to be optimized for adapting with human body structure and the planned control algorithm should have a secure procedure when a incongruity situation which can cause musculoskeletal injury occurs because a wearable robot is attached to a body. The understanding of walking or musculoskeletal motions characteristics must be preceeded and analyzed for developing novel wearable walking assist robot. In this study we tried to find out the capacities of powers and torques of joint actuators to design optimized performances of system and to obtain the analysis data to figure out the characteristics of joint movements during some types of walk. The major types of walk and motion are stair climbing and descending, sit-to-stand motion, and slope walking. In this study all these motions were analyzed experimentally except slope walking.

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Selection of Manageable Diseases for Quality Assessment in Korean Medicine by Delphi Method (한방분야 적정성 평가 대상 질환 선정을 위한 전문가 Delphi 조사)

  • Park, Chang-Hyun;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.129-141
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    • 2016
  • Objectives As awareness of the public about Korean medicine health care and the social demand about improvement for quality of health care service is constantly rising, the quality evaluation of Korean medicine health care service is needed to improve the quality. Through trial of Delphi method, we tried to set the priority in short, medium, long term among the disease which is the subject of quality assessment. Methods Carrying out the delphi survey to 50 experts of korean medicine who were recommended by the 41 member societies of Korean medicine and related organizations, we selected final candidates for quality assessment. It is composed with total 2 rounds, and we investigated the priority in three aspects; the importance of the matter, possibility quality assessment, potential about if there's any chance of improvement. Results By delphi method, we set the priority of quality assessment. Base on the result of the second round, we classified importance of the questions into above average, average, below average, and categorized items as short, medium, long term according on the final priority. We classified of musculoskeletal diseases and diseases of connective tissues and musculoskeletal injury as short term and cerebrovascular disease and disease of nerve system and malignant neoplasm as medium term, disease of digestive organs and diseases, symptoms and abnormal findings in clinical field or inspections which are not categorized as long term. Conclusions We set the subjects of quality assessment by delphi survey by experts, and classified into short, medium, long term. Further research is necessary for execution the Quality Assessment to each of the candidate. Also, we can send feedback to medical institution base on the result of Quality Assessment. then it would be able to induce the improvement in quality of medical institution by itself.

Identifying Complementary and Substitute Relationships between Korean Medicine and Western Medicine using Korea Health Panel dataset (한국의료패널 자료를 이용한 한.양방 의료의 보완 및 대체관계 분석)

  • Choi, Byunghee;Kim, Dong-Soo;Yoo, Wang-Keun;Yun, Youngju;Kwon, Young-Kyu;Lee, Sang-Jae;Lim, Byungmook
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.3
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    • pp.1-18
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    • 2013
  • Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.

Analysis of Biomechanical Effect of the Subtalar Sling Ankle Taping (거골하 관절 현수 테이핑의 생체 역학적 효과 분석)

  • Choi, Mun-Suk;Jeon, Hye-Seon;Kim, Young-Ho
    • Korean Journal of Applied Biomechanics
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    • v.17 no.1
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    • pp.135-144
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    • 2007
  • The purpose of this study was to identify the effect of the subtalar sling ankle taping, by measuring changes in peak plantar pressure and subtalar angle during jump landing and walking in healthy subjects with subtalar sling ankle taping applied of the ankle joint. Fifty healthy subjects(8 males and 7 female, aged 22 to 25) were randomly divided into a participated in this study. They were free of musculoskeletal injury and neurologic deficit in lower extremity. The subjects were asked to perform 5M walking and single leg jump landing by under the guidance of physical therapists. Subtalar motions were typically measured as the angle made between the posterior aspect of the calcaneous and the posterior aspect of the lower leg during walking with taping or not. This measurement were made using a video system (30Hz sampling rate, rectified 60 Hz sampling rate). At the same time, peak lateral and vertical pressure were investigated using pressure distribution platforms(MatScan system) under foot during walking and single leg jump landing with taping or not. Statistical analysis was done by paired t-test and intraclass correlation coefficient [ICC(3.1)], using software SPSS. We have recently demonstrated significantly altered patterns of subtalr joint and peak plantar pressure when applied subtalar sling ankle taping(p<.05). Inversion angle of subtalar joint significantly decreased with taping(p<.05). The result suggest that pressure patterns observed in subjects are likely to result due to significant decrease in stress on ankle joint structures during jump landing and walking. Also, the result that the subtalar sling ankle taping procedure provides greater restiction of motion associated with ankle inversion. However, this study involved asymptomatic subjects without history of ankle inversion injury, further research is needed to assess the motion restraining effect of the subtalar sling ankle taping in subjects with lateral ankle instability.

A Descriptive Analysis of 199 Marathon Participants with Acute Sport Injuries Treated by Acupuncture in the Prehospital Setting (마라톤 후 발생한 스포츠 손상환자 199례의 응급 침 치료에 대한 증례분석)

  • Kim, Kun Hyung;Noh, Seung Hee;Kim, Yu Ri;Lee, Byung Ryul;Kim, Jae Kyu;Yang, Gi Young
    • Journal of Acupuncture Research
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    • v.30 no.1
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    • pp.35-41
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    • 2013
  • Objectives : This study aimed to perform descriptive analysis on demographic characteristics and symptom distribution of 199 marathon participants in Pusan, Korea. Methods : Brief medical charts of 199 marathon participants in 11 marathon rallies who had visited the emergency medical support team of Korean Medicine Hospital, Pusan National University were collected. Participants' demographic and clinical characteristics were descriptively analyzed. Results : More than two third of participants who have visited the support team was male(71.9 %) and their mean age was 44.0(years). The main intervention was manual acupuncture with vigorous stimulation techniques. Most of treated symptoms were lower extremity pain(77.0 %). Knee pain was the most frequently recorded symptoms, following the ankle pain. No information on the safety of acupuncture treatments were reported in the records. Conclusions : Symptom distribution of marathon participants who have visited the emergency medical support team of Korean Medicine Hospital was similar to previous literatures of acute injuries of marathon athletes and runners. The role of acupuncture for emergency support care of acute injuries in marathon participants should be further explored in well-designed clinical studies.

Clinical presentation and specific stabilizing exercise management in Lumbar segmental instability (요추분절의 불안정성에 대한 임상적 소개와 안정성 운동관리)

  • Jung Yeon-Woo;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.155-170
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    • 2003
  • Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. There in evidence of muscle dysfunction related to the control of the movement system. There is a clear link between reduced proprioceptive input, altered slow motor unit recruitment and the development of chronic pain states. Dysfunction in the global and local muscle systems in presented to support the development of a system of classification of muscle function and development of dysfunction related to musculoskeletal pain. The global muscles control range of movement and alignment, and evidence of dysfunction is presented in terms of imbalance in recruitment and length between the global stability muscles and the global mobility muscles. The local stability muscles demonstrate evidence of failure of aeequate segmental control in terms of allowing excessive uncontrolled translation or specific loss of cross-sectional area at the site of pathology Motor recruitment deficits present as altered timing and patterns of recruitment. The evidence of local and global dysfunction allows the development of an integrated model of movement dysfunction. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model in proposed and evidence for the efficacy of the approach provided.

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Factors Influencing Readmission of Convalescent Rehabilitation Patients: Using Health Insurance Review and Assessment Service Claims Data (회복기 재활환자의 재입원에 영향을 미치는 요인: 건강보험 청구자료를 이용하여)

  • Shin, Yo Han;Jeong, Hyoung-Sun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.451-461
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    • 2021
  • Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

Development of a Standardized Clinical Practice Education Program in Occupational Therapy Student (작업치료 대학생의 임상실습 교육 프로그램 개발)

  • Lee, Min-Jae;Lee, Sun-Min
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.27-38
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    • 2022
  • Purpose : This study is aimed to develop and validate the clinical practice education program and clinical competence scale of occupational therapy student. Methods : The development of the clinical practice education program used the delphi technique method, which had a total of five steps. Based on the occupational therapist's job analysis, the first stage assessed the importance of 21 experts, and the second stage examined the importance of 19 new specialists to derive constitutive factors. In the third stage, in-depth interviews were conducted with three experts based on the derived factors, and in the fourth stage, the final clinical practice education program was derived. In the final stage, the details of the clinical training program were drawn up based on the themes and were reviewed by two experts. Structured and unstructured interviews were conducted with 43 job experts. Results : The expert survey through the delphi technique was conducted three times, and content analysis and descriptive statistics were conducted to examine the distribution of responses. The final 11 educational program topics and contents were derived. Topics are confirmation of client information, evaluation and intervention, cognitive therapy, spinal cord injury, brain injury, musculoskeletal disorders, pediatric occupational therapy, interventions in activities of daily living, driving rehabilitation, vocational rehabilitation, occupational therapy assessment tool, safety training and management. Conclusion : The clinical practice education program reduce the difference between school education and clinical education of occupational therapy student. Occupational therapy helps college student understand occupational therapy practices and improve the quality of clinical education. Through more research and supplementation of clinical practice education programs in the future, it is suggested that clinical practice education be successfully operated in various practice institutions and used as basic data for designing and evaluating useful educational models.