• Title/Summary/Keyword: Physical Therapy Patient

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Effect of Joint Mobilization and Insole on Pain, Pelvic Angle, and Foot Pressure in Patient with Sacroiliac Joint Pain : A Randomized Controlled Pilot Trial (관절가동술과 깔창적용이 엉치엉덩관절통증환자의 통증과 골반경사각, 족저압에 미치는 효과: 무작위배정예비임상시험)

  • Lim, Chae-Gil
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.3
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    • pp.383-392
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    • 2020
  • This study was to compare the effects of joint mobilization, treadmill with insole, and joint mobilization and treadmill with insole on pain, pelvic angle, and foot pressure in patients with sacroiliac joint pain. 24 patients randomly assigned to joint mobilization group(n=8), treadmill with insole group(n=8), or joint mobilization and treadmill with insole group(n=8). Each groups were conducted 30 minutes a day, two days a week for four weeks. Pain was evaluated using visual analogue scale and pelvic angle was measured using palpation meter and foot pressure(fore/rear ratio) was measured using Gateview AFA-50 before intervention and after 4 weeks. All groups were significant differences pain in intragroup(p<.01). In pelvic angle, the joint mobilization group was statistically significant in the anterior tilt only, the joint mobilization and treadmill with insole group showed statistically significant improvement in both anterior and posterior tilt(p<.01), and the treadmill with insole group did not show any statistically significant change(p>.05). Also the joint mobilization and treadmill with insole group were significant differences in foot pressure(p<.01). All the interventions reduce sacroiliac joint pain and joint mobilization and treadmill with insole training are most effective changes in pelvic angle and foot pressure. This study can be used as a basic data for prevention of injury, posture correction and gait training in patients with sacroiliac joint pain, as well as chronic low back pain and plantar pressure problem.

Assessment of Dental Noise Environment of a Pediatric Dentist (소아치과의사의 치과 소음 환경에 대한 평가)

  • Cho, Hyeonmin;Kim, Ik-Hwan;Cho, Seunghyun;Song, Je Seon;Lee, Jaeho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.2
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    • pp.209-220
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    • 2021
  • The noise is defined as unwanted sound that causes discomfort and physical changes. This study was conducted to evaluate intensity of noise in the pediatric dental clinic and to investigate noise environment of a pediatric dentist. Human ear shaped microphone and mobile noise level meter were used for recording noise and calculating intensity of noise. By recording according to the method specified by Korea Occupational Safety and Health Agency (KOSHA) of Korea Ministry of labor and employment, the following results were obtained. For 16 experimental days, 8 hour time weighted average (8hr-TWA) was 49.33 dBA (A-weighted deci-Bell) on daily average with maximum 58.54 dBA and minimum 33.97 dBA. And Dose was 0.49% on daily average with maximum 1.28%, minimum 0.04%. These values are less than criteria of KOSHA standard (85 dBA, 100%). Comparing the highest noise level for each patient, pulp therapy group and Frankel grade I group were the highest. The intensity of dental noise of pediatric dental clinic didn't meet standard of KOSHA. It is necessary to re-evaluate noise environment by establishing new standards considering environment of pediatric dental clinic.

A Suggestions of Future Direction of the Integrated Community Care Business for Improvement of the Elderly's Life Care (노인의 라이프케어 향상을 위한 지역사회 통합돌봄사업 미래 방향에 대한 제시)

  • Yang, Seung-Hoon
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.423-432
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    • 2021
  • In this study, we investigated and the following conclusions are presented by identifying the current status and problems in order to expand the future's value of the community care project introduced and implemented to improve the quality and care for the elderly's life. First, the needs analysis of the elderly receiving services is composed of patient-centered rather than investigator-centered, and in particular, medical management through medical staff visits should be strengthened, and specialized service items according to gender, age, disability type, and personal preference should be strengthened. This will have to be gradually strengthened. Second, by analyzing the satisfaction, redundancy, and effectiveness of service items, we save money, and consider the consumer-oriented service item composition and application of items necessary for new services. Third, through the introduction of an integrated schedule management system, it is necessary to specialize in pre-booking and visit schedule management between the elderly and the direct service organizations that provide services. Fourth, as an effort to solve the financial problem, it is necessary to prepare a rational resource sharing system with health and medical finance, long-term care insurance system, and social welfare financial project. and it may consider that putting the medical personnel who are from local public medical college input. Through these proposals, the community care business will be able to complete and have future value as a universal aged care system.

Effects of Dynamic Tubing Gait Training on Postural Alignment, Gait, and Quality of Life in Chronic Patients with Parkinson's Disease : Case Study (동적탄력튜빙 보행훈련 프로그램이 만성 파킨슨병 환자의 자세정렬과 보행능력과 삶의 질에 미치는 영향 : 사례연구)

  • Lee, Dong-Ryul
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.363-377
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    • 2021
  • The present study investigated the effects of dynamic tubing gait training(I and II) on the postural alignment, gait, and quality of life in chronic patients with Parkinson's disease. This study is based on the case study that recruited a total of 3 patients with chronic Parkinson's disease (Hoehn and Yahr Stage of 1 to 3 each one person). Dynamic tubing gait training (I and II) applied to chronic patients with Parkinson's disease for 25 sessions, 30 minutes a day, 5 days a week, over 5 weeks period. To investigate the effects of this study, evaluating using the postural alignment test, muscle activity tests, gait analysis, and quality of life scale for patient with Parkinson's disease. After the intervention of Dynamic tubing gait training (I and II), Trunk flexion was decreased. Also, during walking from initial contact (IC) to mid stance (Mst), muscle activity of Quadriceps, Hamstring, and Tibialis Anterior (TA) was increased and muscle activity of Gastrocnemius was decreased. The muscle activation of Erector Spinae (ES T12, L3) was increased in the H&Y I and III stages and decreased in the H&Y II stage. Length of gait line, single support line, ant/post position and lateral symmetry of center of pressure (COP) parameters improved. The spatio-temporal gait parameters including of step length, stride length, and velocity was increased, and cadence decreased. Further the quality of life of patients with Parkinson's disease was improved. Based on these findings, Dynamic tubing gait training (I and II) could be applied as a new approach to improve posture, gait, quality of life in chronic patients with Parkinson's disease for more than 5 years, whose drug resistance is halved.

Efficiency of Staging Work-Ups in the Evaluation of Carcinoma of the Uterine Cervix (자궁경부암에 있어서 병기결정을 위한 검사의 효용성)

  • Kim, Jae-Sung;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.271-276
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    • 1991
  • A series of 510 patients with carcinoma of the uterine cervix given the curative radiation therapy from March 1979 through December 1986 was evaluated to determine the value of intravenous pyelography (IVP), cystoscopy, sigmoidoscopy, and abdomino-pelvic CT as staging work-up prior to treatment. On IVP and cystoscopy, $10.7\%$(49/456) and $5.3\%$(24/452) showed abnormality, respectively, but only $0.7\%$(3/413) did on sigmoidoscopy. As a result of these work-ups prerequisite to FIGO staging, twenty six ($5.1\%$) out of 510 patients were upstaged from the stage determined by the findings of physical examination alone. The proportions of upstaging in each stage were as follows; none in stage IB (35), IIA (89) and IIIA (8), $7.9\%$(20/252) in stage IIB (14 patients to FIGO stage IIIB, 6 patients to FIGO stage IVA), and $4.8\%$(6/126) in stage IIIB (all to FIGO stage IVA). Positive findings of staging work-ups were found only in patients with advanced stages of stage IIB or over determined by physical examination alone but not in those with earlier stages. CT was performed in 337 patients. CT detected pelvic lymph node (LN) enlargement in $25.2\%$ (85/337) and paraaortic LN enlargement in $7.4\%$(25/337). Pelvic LN positivity was well correlated with increasing stage but paraaortic LN positivity was not. In the evaluation of parametrial involvement, CT findings were in accordance with those of physical examination only in $65.6\%$ (442/674). When compared with endoscopic studeies, CT had much lower positive predictive value than negative predicitive value in the evaluation of adjacent organ invasion. The staging work-ups should be individualized by the disease extent of each patient, and then the efficiency of work-uus may be increased without compromising the appropriate FIGO staging and treatment.

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Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
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    • v.31 no.4
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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PRELIMINARY STUDY OF MENTAL REPRESENTATIONS OF PRESCHOOL CHILDREN EXPERIENCING SINGLE, SEVERE TRAUMA (심한 정신적 외상 경험을 한 학령 전기 아동의 정신적 표상에 대한 예비연구)

  • Eon, So-Yong;Song, Won-Woung;Oh, Kyung-Ja;Choi, Eui-Gyum;Shim, Eun-Ji;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.61-74
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    • 2004
  • Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

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The Effect of Nasal BiPAP Ventilation in Acute Exacerbation of Chronic Obstructive Airway Disease (만성 기도폐쇄환자에서 급성 호흡 부전시 BiPAP 환기법의 치료 효과)

  • Cho, Young-Bok;Kim, Ki-Beom;Lee, Hak-Jun;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.190-200
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    • 1996
  • Background : Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. Method : We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure $6-8cmH_2O$ and an expiratory positive airway pressure $3-4cmH_2O$. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. Results : Pretreatment and after 3 days of treatment, mean $PaO_2$ was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and $PaCO_2$ was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in cr group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean $PaO_2$, $PaCO_2$ and pH respectively. Conclusion: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPD, is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.

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Arthroscopic Iliopsoas Tenotomy of Iliopsoas Impingement after Total Hip Arthroplasty (고관절 전치환술 후 발생한 장요건 충돌의 관절경하 장요건 절단술)

  • Huh, Soon Ho;Choi, Byeong Yeol;Han, Sang Roc;Chung, Woo Chull
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.125-133
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    • 2021
  • Purpose: The clinical outcomes were investigated to determine if arthroscopic management is a useful method for 19 hips with iliopsoas tendon impingement (IPI) after total hip arthroplasty (THA). Materials and Methods: Eighteen patients (19 hips), who complained of groin pain and flexion pain that persisted after THA from September 2013 to December 2019, were the subjects of this investigation. The mean time to manifestation after THA was four months (range, 1-9 months) in patients of an average age of 60 years (range, 50-69 years). Thirteen out of 18 patients underwent THA using the direct anterior approach and five by the lateral approach. IPI was diagnosed by the medical history, physical examination, blood test, radiographic examination using X-ray and computed tomography, and topical injection therapy. All patients underwent arthroscopic treatment and a dynamic arthroscopic physical examination after exposure to the iliopsoas tendon revealed impingement. Tenotomy was then performed on the muscle portion through the total tendon portion. Symptoms and pain levels of preoperative, postoperative and follow-up period were investigated and compared. Results: The Western Ontario and McMaster Universities Osteoarthritis Index score decreased from an average of 58.4 (range, 40-88) before surgery to an average of 35.0 (range, 15-76) after surgery. Similarly, the visual analogue scale decreased from an average of 4.0 (range, 2-6) before surgery to an average of 1.4 (range, 0-4) after surgery. Sixteen patients (88.9%) showed pain relief and improvement in the straight leg raise test, and two patients showed postoperative muscle weakness and sustained pain. In the follow-up period, muscle weakness improved. One patient underwent arthroscopic iliopsoas tenotomy at the lesser trochanteric level but the symptoms persisted. The clinical symptoms were improved after one more tenotomy at the joint level. Conclusion: Arthroscopic iliopsoas tenotomy performed in patients with IPI after THA showed good clinical results.