• PNF and Movement
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• 제15권2호
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• pp.115-124
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• 2017

Purpose: Researchers found that blocks of evidence-based practice (EBP) implementation lacked opportunities for EBP education. The study found that physical therapists had negative views of research as well as their roles in EBP, lacked confidence in EBP, and had limited access to web-based materials. The purpose of this study was to highlight the importance of information research technology for efficient EBP in a clinical environment. Methods: The web-based information research technologies that should be used for sustainable EBP include: the clinical practice guideline (CPG) and PubMed's My NCBI service. Journal mailing services and other academic information sources should also be used to gather information from RSS feeds. An EBP library or archive must be created. A site that provides EBP-specific information is also needed. Results: We should usually do EBP. Practitioners must learn and use information technologies that will help them improve their EBP skills. Conclusion: Facilitating EBP implementation and building an EBP system require related education as well as a practical work environment and equipment. However, the highest priority is individual efforts and trial. Information technology will complement the lack of time. It is important to use information research technology to overcome real obstacles. Lasting EBP must use a number of web-based information research technologies to overcome the practical challenges encountered in EBP implementation.

• PNF and Movement
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• 제14권3호
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• pp.157-176
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• 2016

Purpose: The purpose of this study was to share an experience about processes and lessons learned to execute evidence-based practice (EBP) in neurological physical therapy. Methods: The most important thing in applying EBP to practice is to search, find, and appraise the existing evidence. Many evidence databases are available, such as CENTRAL, PEDro, PUBMED, and EMBASE. However, the knowledge represented in these databases is not always perfect. The practice model is a set of processes to resolve client problems. Therapists should make hypothesis-focused decisions through EBP. Integrating clinical reasoning and evidence is most important when it comes to the execution of EBP. Results: The process of EBP consisted of following: coming up with clinical questions, followed by searching for, appraising, evaluating, and integrating evidence. To integrate EBP into practice, it is necessary to consider clinical expertise, patient value and preferences, as well as research wth the best evidence. We provided an example of a clinical case with a stroke patient to show how this process and framework concerning clinical reasoning through evidences can be integrateds. During this process, we also utilized information technology to improve EBP ability. Conclusion: We should recognize what manner of information is needed to resolve eash patient's problem, and we should search for this information efficiently. Then, we should judge the value of the information obtained as it applies, to the clinical setting.

• 대한물리치료과학회지
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• 제5권4호
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• pp.785-794
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• 1998

We have made a survey of 40 patients in the university hospitals and oriental medical centers in Seoul from Sep. 1, 1997 to Mar. 1, 1998. We sampled 25 of them and the result shows that there were 12 MCA damaged patients(48%), 5 SAH(20%), 5 ACA(20%), 2 PCA (8%), 1 PCOA(4%). The number of MCA patients were the most. 1. As the cause of each disease, 4 of the 12 MCA damaged patients(33.35%) have infarction and cerebral hemorrhage, 2 of 5 SAH patients(40%) have cerebral hemorrhage and head injury, 3 ACA damaged patients have cerebral hemorrhage. 11 of 25 brain bloodvessel damaged patients(44%) were hemorrhage patients. 2. Rt. hemiparesis was the main symptom of 6 of 12 MCA damaged patients(50%) and 3 of 5 SAH patients(60%), and the main symptom of 3 of 5 ACA patients(60%) was Lt. hemiparesis. The main symptom of 13 of 25 brain bloodvessel damaged patients(52%) was Lt. hemiparesis 11 of them(44%) Rt. hemiparesis, and 1 of them(8.3%) Quadriplegia. 3. Language was the most well preserved function. 12 MCA damaged patients could understand language. 4. Retraction of shoulder girdle, among VIE flexor synergy, was the most frequent element because 9 of 12 MCA damaged patients had it. Among VIE flexor synergy, 5 SAH patient's most frequent synergy was Elbow flexion because all of them had it. All of 5 ACA damaged patients have shoulder girdle elevation, shoulder joint, hyperextension, abduction, and external rotation among VIE flexor synergy. 5. 7 of 12 MCA damaged patients(58.3%) were stereognosis handicapped patients, 3 of 5 SAH patients(60%) have handicap of position sense, light touch, and temperature, 3 of 5 ACA patients(60%) have position handicap. 13 of brain bloodvessel damaged patients(52%) have light touch handicap. 6. 8 of MCA damaged patients(66.7%) have facial palsy, 4 of SAH damaged patients(80%) have memory and action decline, and 3 of ACA damaged patients(60%) have action decline and facial palsy. The problem of Hemiplegia is very extensive from muscle weakness, atrophy, or deformation to psychical problems. Therefore physical therapists should have sufficient interest in psychological handicap as well as physical handicap as they deal with adult hemiplegia.

• International Journal of Contents
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• 제6권1호
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• pp.1-5
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• 2010

Kinesio Taping (KT) is widely used by physical therapists to treat a variety of neuromusculoskeletal disorders. In this study it was examined whether or not KT has an effect on the peak torque and muscle activity of the quadriceps muscles in healthy subjects. KT was applied to the anterior thigh and tibia of fifteen healthy males (mean age, 25.42${\pm}$1.38 years, mean body height 178.58${\pm}$3.03 cm, mean body weight 71.58${\pm}$6.42 kg) who have no problem within past 2 months. The quadriceps peak torque was assessed using an isokinetic dynamometer while the mean data of muscle activity was measured by surface electromyography (EMG). The maximal voluntary isometric contraction was carried out on all subjects at $0^{\circ}$, $30^{\circ}$ and $60^{\circ}$ before, during, and after KT. There were no significant differences in the peak torque and mean data of quadriceps muscle(vastus lateralis, rectus femoris, and vastus medialis oblique) activity at $0^{\circ}$, $30^{\circ}$ and $60^{\circ}$ before, during and after application of KT (p>.05). From this study it could be concluded that the application of KT to the anterior thigh and tibia doesn't affect the peak torque and the muscle activity.

• The Journal of Korean Physical Therapy
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• 제27권4호
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• pp.183-189
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• 2015

Purpose: The aim of this study was to examine the test-retest and inter-rater reliability of the pediatric functional muscle testing (PFMT) when applied to children with developmental delay. Methods: Sixteen children with developmental delay (seven females, nine males) participated in this study. For the inter-rater reliability, each was scored on the PMFT by two pediatric physical therapists with more than 8 years of clinical experience on the same day. For assessment of the test-retest reliability, one therapist tested the children again within 10 days. The second measurement was performed by taking a first measurement in video. Intraclass correlation coefficient (ICC) was calculated to determine the test-retest and inter-rater reliability of the PFMT, and Chronbach's alpha was used to measure internal consistency. Results: The results of this study were as follows: 1) The test-retest ICC of the score of the infant action month and the right side of the PFMT was from 0.53 to 1.00 and from 0.63 to 0.99, respectively. 2) The inter-rater ICC of the score of the infant action month and the right side of the PFMT was from 0.66 to 1.00 and from 0.64 to 1.00, respectively. 3) Chronbach's alpha was 0.93. The internal consistency indicated excellent. Conclusion: In conclusion, this study showed that the test-retest and inter-rater reliability of the PFMT was relatively high, except for a few items. Therefore, it can be suggested that the PFMT will be a useful tool for measurement of muscle strength for children with developmental delay if it be some modifications.

• The Journal of Korean Physical Therapy
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• 제27권4호
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• pp.228-233
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• 2015

Purpose: Gait is the most basic element when evaluating the quality of life with activities of daily living under ordinary life circumstances. Symmetrical use of the lower extremities requires complicated coordination of all limbs. Thus, this study examined asymmetry of muscle activity quadriceps femoris and tibialis anterior as a baseline for training during over-ground walking and stair walking of stroke patients. Methods: Subjects were 14 stroke patients included as one experimental group. Gait speed used in this study was determined by the subject. Low extremity paretic and non-paretic EMG was compared using the surface EMG system. Results: The low extremity EMG difference was statistically significant during over-ground walking and stair walking (p<0.05). The result of low extremity EMG substituted symmetry ratio formula was compared to EMG symmetry ratio in both legs during over-ground walking and stair walking. The average symmetry ratio of quadriceps femoris during over-ground walking was 0.65, and average symmetry ratio of quadriceps femoris during stair walking was 0.47, with significant difference (p<0.05). Conclusion: EMG data was higher in stair walking than over-ground walking. However, in the comparison of symmetry ratio, asymmetric EMG of quadriceps femoris was significantly increased during stair walking. These findings suggested that application of stair walking for strengthening of both legs can be positive, but the key factor is maintaining asymmetrical posture of both legs. Therefore, physical therapists should make an effort to reduce asymmetry of quadriceps femoris power during stair walking by stroke patients.

• The Journal of Korean Physical Therapy
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• 제32권2호
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• pp.88-93
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• 2020

Purpose: This study examined the inter-rater reliability of cervical proprioception, dynamic balance ability, and ankle dorsiflexion range of motion using STARmat^®, which is a practical clinical tool that can provide practitioners and patients with quantitative and qualitative results. Methods: Thirty healthy young subjects were enrolled in this study, and two well-trained physical therapists participated as a tester. Two testers measured the cervical joint position error at the starting position after neck flexion, extension, side bending, and rotation; three dynamic balance tests, including anterior excursion, anterior reaching with single leg balance, and posterior diagonal excursion; and ankle dorsiflexion range of motion using STARmat^®. The intra-class correlation coefficient (ICC) was used to determine the inter-rater reliability of the tests. Results: The inter-rater reliability for the cervical proprioception ranged from moderate to good (0.66 to 0.83), particularly for flexion (0.82), extension (0.70), right side bending (0.73), left side bending (0.71), right rotation (0.83), and left rotation (0.66). For the dynamic balance, the inter-rater reliability ranged from good to excellent (0.87 to 0.91), particularly for anterior excursion (0.86), posterior diagonal excursion (0.87 to 0.89), and anterior reaching with a single leg balance (0.90 to 0.91). In addition, for the ankle dorsiflexion range of motion, the ICC for the inter-rater reliability ranged from 0.95 to 0.96. Conclusion: STARmat^® is a reliable tool for measuring cervical proprioception, dynamic balance tests, and ankle dorsiflexion range of motion in healthy young adults.

• 대한정형도수물리치료학회지
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• 제9권2호
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• pp.25-45
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• 2003

Sling exercise treatment(S-E-T) is a therapeutic exercise based on scientific studies for the purpose of treating musculoskeletal or neurological disorders thereby improving strength, endurance, and skills for sensory-motor integration. Exercise resistance and intensity can be modified in various ways by changing the length of rope, patient position, therapist's manual resistance, and using elastic rope. The therapist can also progress to successively higher levels of exercise resistance and intensity by changing the position of the hanging point: the subject of this article. In brief, there are three axial components in S-E-T; hanging point, motor axis, and suspension point. The hanging point can be changed in several ways in relation to the joint; axial, superior, inferior, medial, and posterior hanging points. The position of the hanging point affects the amount of load on agonist and antagonist muscles as well as on the range of motion. To create an advanced exercise program, selection of hanging point can be two-dimensional such as superior-lateral or anterior-medial. Therapists, therefore, can freely but carefully select the best hanging point based on the purpose of the exercise and their level of knowledge in S-E-T.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.19-29
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• 2017

Background: Patients after rotator cuff (RC) surgery experienced pain, weakness and limited of motion of the shoulder. Physical therapists have used heat therapy, electrotherapy, range of motion (ROM) exercise and other methods to treat patients after RC surgery. In addition, functional taping is also used to support joint movement and to increase shoulder joint stability. Objects: The purpose of this study was to determine the initial effects of functional taping using non-elastic tape on pain, strength and ROM of the shoulder following RC surgery. Methods: Forty-eight patients with who underwent RC surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, $n_1=25$) and a control group (CG, $n_2=23$). First, non-allergic tape was applied to the shoulder to prevent skin irritation. The EG applied functional taping using non-elastic tape and the CG applied sham taping using elastic tape. Assessment tools included the shoulder pain and disability index for functional activity score, visual analog scale for level of pain, shoulder muscle strength, hand grip strength and ROM testing. Results: Pain score in the both group significantly decreased (p<.05), and change in pain score of in the EG increased significantly than in the CG (p<.05). Shoulder strength and ROM in the both group significantly increased (p<.05). Especially external rotation and extension of the shoulder ROM in the EG increased significantly more than in the CG (p<.05), but the rate of change in the two groups showed no significant difference. Conclusion: These results suggest that functional taping using non-elastic tape was initially effective in decreasing pain score level in patients with RC surgery.

• 한국전문물리치료학회지
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• 제9권2호
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• pp.115-131
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• 2002

Functional electrical stimulation (FES) training of the knee extensors is a useful way to rehabilitate the ability to stand and walk. However, training using FES has not been able to solve the problem of fatigue; clinical application of FES quickly produces muscle fatigue, due to the continuous activation of the muscles of the lower extremity. Therefore, reduction of muscle fatigue is an important factor in increasing the effectiveness of FES training in paraplegia. Intermittent high frequency alternating stimulation is a method that combines the advantages of high frequency (leading to strong muscle contractions) and alternating stimulation (reducing muscle fatigue), thereby continuously strengthening muscles. It is not known whether low frequency simultaneous stimulation results in stronger muscle contraction than high frequency alternating stimulation. This study compared the effectiveness of high frequency alternating stimulation with low frequency synchronized stimulation. Muscle power using FES on the quadriceps of 20 normal subjects were compared. Intermittent high frequency alternating stimulation did not produce more powerful muscle contraction than intermittent low frequency synchronized stimulation, because the muscle characteristics differed individually. Significant individual variation according to muscle characteristics was founded when applying FES. Accordingly, when physical therapists use FES to treat patients, they must be aware of individual variation in muscle characteristics.