• Journal of the Korean Society of Physical Medicine
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• v.18 no.1
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• pp.99-110
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• 2023

PURPOSE: This study was conducted to suggest a way to easily understand and utilize the International Classification of Functioning, Disability and Health (ICF) or Korean Standard Classification of Functioning, Disability and Health (KCF), a common and standard language related to health information. METHODS: The tools used by physical therapists to evaluate the functioning of neurological patients were collected from 10 domestic hospitals. By applying the ICF linking rule, two experts compared, analyzed, and linked the concepts in the items of the collected tools and the ICF/KCF codes. The frequency of use of the selected tool, the matching rate of the liking results of two experts, and the number of the codes linked were treated as descriptive statistics and the code set was presented as a list. RESULTS: The berg balance scale, trunk impairment scale, timed up and go test, functional ambulation category, 6 Minute walk test, manual muscle test, and range of motion measurements were the most commonly used tools for evaluating the functioning. The total number of items of the seven tools was 33, and the codes linked to the ICF/KCF were 69. Twenty-two codes were mapped, excluding duplicate codes. Ten codes in the body function, 11 codes in the activity, and one code in the environmental factor were included. CONCLUSION: The information on the development process of the code set will increase the understanding of ICF/KCF and the developed code set can conveniently be used for collecting patients' functioning information.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• 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.

• Physical Therapy Korea
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• v.19 no.3
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• pp.124-131
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• 2012

Most conventional instruments measuring disability rely on total score by simply adding individual item responses, which is dependent on the items chosen to represent the underlying construct (test-dependent) and a test statistic, such as coefficient alpha for the estimate of reliability, varying from sample to sample (sample-dependent). By contrast, item response theory (IRT) method focuses on the psychometric properties of the test items instead of the instrument as a whole. By estimating probability that a respondent will select a particular rating for an item, item difficulty and person ability (or disability) can be placed on same linear continuum. These estimates are invariant regardless of the item used (test-free measurement) and the ability of sample applied (sample-free measurement). These advantages of IRT allow the creation of invariantly calibrated large item banks that precisely discriminate the disability levels of individuals. Computer adaptive testing (CAT) method often requiring a testing algorithm promise a means for administering items in a way that is both efficient and precise. This method permits selectively administering items that are closely matched to the ability level of individuals (measurement precision) and measuring the ability without the loss of precision provided by the full item bank (measurement efficiency). These measurement properties can reasonably be achieved using IRT and CAT method. This article aims to investigate comprehensive overview of the existing disability instrument for back pain and to inform physical therapists of an alternative innovative way overcoming the shortcomings of conventional disability instruments. An understanding of IRT and CAT method will equip physical therapist with skills in interpreting the measurement properties of disability instruments developed using the methods.

• Physical Therapy Korea
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• v.15 no.4
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• pp.43-49
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• 2008

The objective of this study was to compare the differences on the activity and power of the wrist flexors and extensors in subjects before the use of a wrist extension splint, after nighttime wearing of the splint, and after daytime wearing of the splint. Ten healthy male and ten healthy female students (mean: $22.4{\pm}1.2$ years old) volunteered to wear custom-made wrist splints either during the night or during the day, The hand force of the wrist flexor and extensor, and grip force were measured by PowerTrack II and Dynatron, respectively. At the same time, the activities of the wrist flexor and extensor were recorded by' surface electromyography. The maximal hand force and motor unit recruitment of the flexor carpi ulnatis (FCU) increased significantly (p<.05) when tile subjects wore the wrist splints during the daytime, but the maximal hand power of the FCU decreased with nighttime use of the splints. The maximal hand power and motor unit recruitment of the extensor carpi radialis (ECR) and the ECR/FCU ratio decreased both during nighttime and daytime use. The decrement of the ECR/FCU ratio was significant (p<.05). Wearing a wrist extension splint during nighttime led to the maintenance of a lengthened position of the wrist flexor, resulting in the wrist flexor becoming weak. Wearing a wrist extension splint during the day induced the wrist flexors to be greater. In healthy people, the imbalance between the wrist flexors and extensors may be caused by the use of a wrist extension splint. This study indicates that therapists have to consider whether a splint will be effective, as well as the wearing time, when prescribing splints to people with problems of the musculoskeletal system.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.1
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• pp.1-10
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• 2007

Purpose : To identify the effects of Hold-Relax of proprioceptive neuromuscular facilitation (PNF) on the functional improvement of patients with neck myofascial pain syndrome. Methode : The present research investigated 60 patients with neck myofascial syndrome, dividing them into a group doing Hold-Relax of proprioceptive neuromuscular facilitation and a group doing Stretching, This study examined degree of recovery from neck pain by comparing their neck myofascial pain syndrome before and after the treatment, and compared two groups to find difference in the degree of recovery from myofascial pain syndrome. Results : 1. For Hold-Relax of proprioceptive neuromuscular facilitation group, the pain rating score (PRS) were significantly decreased for six weeks treatment. 2. For Stretching group, the pain rating score (PRS) did not indicate significant decrease for six weeks treatment. 3. For Hold-Relax of proprioceptive neuromuscular facilitation group, range of motion of flexion, left rotation, right rotation indicated significant difference after pre test and after two week but no significant difference after four week. 4. For Stretching group, range of motion of flexion, left rotation, and right rotation except extension indicated significant difference after pre test and after two week but no significant difference after four week. Conclusion : The Hold-Relax of proprioceptive neuromuscular facilitation is considered to be effective in increasing joint range of motion of patient and decreasing pain. Accordingly physical therapists has to learn a wide range of patterns and to develop various treatment techniques.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.282-287
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• 2013

Purpose: The purpose of this study was to investigate the characteristics of patients with Chronic Low Back Pain (CLBP) in disability, pain, and cognition, and to compare those characteristics to the ICF concept analyzing the association between World Health Organization Disability Assessment Schedule 2.0: 12 item-interviewer version (WHODAS 2.0) and those of scales i.e. Oswestry Disability Index (ODI), the Short-Form McGill Pain Questionnaire (SFMPQ), and the Fear avoidance & belief questionnaire (FABQ). Methods: A total of 91 patients with CLBP were invited to participate in the study. Physical therapists interviewed all participants using SFMPQ, FABQ, ODI, and WHODAS 2.0 for collection of information on pain, cognition, and functional level data. Subjects scored their disability, pain, and cognition related to LBP using WHODAS 2.0, ODI, SFMPQ, and FABQ. Data analysis was performed using the Spearman correlation coefficient. Results: A positive relationship was observed between WHODAS 2.0 and each scale indicating that lower back specific disability components could be related to the ICF concept in ODI (r=0.77). Pain intensity and pain oriented movement were found to be related to general functioning in patients with CLBP (r=0.52, r=0.55, respectively). Conclusion: It can be suggested that the specific disability scale for LBP, ODI can be related to the ICF concept, WHODAS 2.0, and it may be a useful measure for patients with CLBP.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.4
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• pp.139-146
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• 2017

PURPOSE: The purpose of this study was to systematically analyze the reliability and validity of the Korean-version of the balance assessment tools. METHODS: Two reviewers of this study independently evaluated the titles of articles and abstracts of studies published until December 2016 through electronic databases (RISS, NDSL, KISS, DBpia) using the keywords "Balance or posture or postural control or postural stability", "Test or assessment or measurement or outcome measure or assessment tool or measurement tool", "Korean version", "Reliability" and "Validity". Regarding the questions considered suitable for the purpose of this study, consensus was reached after reading the full text. Selecting journals suitable for the purpose of the study, they were analyzed as data. RESULTS: The reviewers selected nine papers suitable for the purpose of this study, and Korean-version of the balance assessment tools, included the Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC) scale, Postural Assessment Scale for Stroke (PASS), Motor Assessment Scale (MAS), Trunk Impairment Scale (TIS), Falls Efficacy Scale (FES), Tinetti-Balance scale, Fullerton Advanced Balance (FAB) scale, and Function In Sitting Test (FIST). Our study showed that the reliability and validity of the Korean-version of the balance assessment tools were high. CONCLUSION: The Korean-version of the balance assessment tools with high reliability and validity would enable physical therapists to make a more accurate evaluation of balance.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.125-132
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• 2019

PURPOSE: The aim of this study was to help physical therapists involved in rehabilitation in the direction of clinical intervention in the treatment of stroke patients by understanding how an activity restriction of stroke patients affects depression and the quality of life associated with health. METHODS: This study assessed 404 stroke patients from the Korean National Health and Nutritional Examination Survey. The subjects were divided into two categories: activity restriction and non-activity restriction. The variables used in this study were depression diagnosed by a doctor and EQ-5D, which evaluates the quality of life. Logistic regression analysis was used to calculate the odds ratios associations of activity restriction with depression and the quality of life in stroke patients. RESULTS: The diagnosis of depression with an activity restriction was 11.2%, while 4.8% of those with non-activity restrictions were diagnosed with depression (p<.05), and the EQ-5D index of was .68±.03, .88±.01(p<.05). The odds ratio for depression with an activity restriction was 3.37 (95% CI, 1.49-7.63) compared to the non-activity restriction. A statistically significant difference in the odds ratio was observed for each item in the EQ-5D. CONCLUSION: Activity restriction in stroke patients increases the probability of depression, and reduces the quality of life significantly. The treatment for stroke patients should be approached, taking psychological factors into account. In addition, rehabilitation programs that can be performed systematically and continuously are deemed necessary.

• The Journal of Korean Physical Therapy
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• v.22 no.4
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• pp.29-33
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• 2010

Purpose: The purpose of this study was to assess and compare the reliability of the Modified Tardieu Scale (MTS) with the Modified Ashworth Scale (MAS) in patients with hemiplegia. Methods: Two experienced physical therapists examined twenty six patients (17 male and 9 female) with an age range of 19-83 years (mean=51.9 SD=15.2). They assessed the elbow flexor/extensor muscle spasticity in the affected side. Interand intra-rater reliability of the MAS and the MTS were calculated using kappa statistics. Intraclass correlation coefficient (ICC) was calculated to determine the inter- and intra-rater reliability of the angle of muscle reactions (R2-R1). Results: The intra-rater reliability of the MAS (K=0.39-0.55) and MTS (K=0.33-0.55) was fair to moderate. The inter-rater reliability was significantly higheras measured with MTS (K=0.54-0.66) in comparison with MAS (K=0.52). Intra-rater reliability of R2-R1 was moderate to almost perfect (ICC=0.52-0.86), and inter-rater reliability was substantial (ICC=0.74-0.76). Conclusion: The MTS provides higher inter-rater reliability compared with the MAS in hemiplegia patient analysis, but intra-rater reliability of both scales was not significantly different. Thus further research is needed to examine not only reliability, but also validity of these measurement systems.