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The Effect of Progressive Muscle Relaxation using Biofeedback on Stress Response and Natural Killer Cell in first Clinical Practice of Nursing Students (바이오휘드백을 이용한 점진적 근육이완훈련이 스트레스반응과 면역반응에 미치는 효과)

  • Kim Keum-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.109-121
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    • 2000
  • Increasingly nursing science is embracing the concepts and methodology derived from psycho-neuroimmunology. It has been previously shown that stress increases and immune function declines in students undergoing examinations. To date, however, no many studies have been reported on stress levels, immune function and interventions in Korean students undergoing their first clinical nursing rotation. It was proposed that nursing students during their first clinical rotation experience increase in stress because of the novelty of the situation and their lack of clinical knowledge. It was also hypothesized that biofeedback and progressive relaxation, methods of self-regulation of involuntary autonomic nervous system responses, would reduce the stress response. The purpose of this study is to test the effectiveness of progressive muscle laxation using biofeedback The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS) and the values of ephinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were thirty nursing students divided into two groups: experimental group was progressive muscle relaxation group using biofeedback and control group. This study was conducted for 8 weeks of clinical practice. Biofeedback training was done by software developed by J&J company (1-410 form for progressive muscle training). Progressive muscle relaxation training according to Jacobson's Theory was done by messaged word from biofeedback. The data was analyzed using Chronbach' ${\alpha}$ and t-test of the SPSS program and the significance level of statistics was 5%. The results of the study were : 1) The progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress(t=-4.248, p<.001) under clinical practice stress conditions. 2) The progressive muscle relaxation training using biofeedback was not effective for the values of epinephrine(t=-1.294, p=.206). 3) The progressive muscle relaxation training using biofeedback was effective for the reduction of systolic blood pressure (t=-2.757, p=.01). 4) The progressive muscle relaxation training using biofeedback was effective for the reduction of diastolic blood pressure (p=-2.032, 0=.05). 5) The progressive muscle relaxation training using biofeedback was not effective for the reduction of pulse rate(t=-15, p=.988). 6) The progressive muscle relaxation training using biofeedback was effective for the maintenance of natural killer cells (t=2.381, p=02). The first clinical rotation for student nurses is a stressful experience as seen by the rise in the SOS in the control group. Biofeedback using progressive muscle relaxation were effective in preventing the rise of symptoms of stress and the blood pressure means when comparing the pre to post clinical experience, The mean natural killer cell count was depressed in the control group but not significantly different in the experimental groups, It is proposed here that stress via the hypothalamic - pituitary - adrenal axis suppressed the NK cell count whereas the relaxation methods prevented the rise in stress and the resulting immune depression. We recommend relaxation techniques using biofeedback as a health promotion technique to reduce psychological stress. In summary. the progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress under clinical practice stress conditions.

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Comparison of Tibial Tuberosity Transposition and Anti-rotation Suture for Medial Patellar Luxation in 133 Small-breed Dogs

  • Son, Chansoo;Cheong, Jongtae;Lee, Joo Myoung
    • Journal of Veterinary Clinics
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    • v.35 no.5
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    • pp.200-205
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    • 2018
  • This retrospective study is designed to compare the clinical results of tibial tuberosity transposition (TTT) and anti-rotation suture (ARS) treatments for medial patellar luxation (MPL). Medical records of 133 dogs were reviewed that had undergone surgical correction of MPL between January 2013 and May 2017. MPL correction was performed on 182 stifles, with TTT and ARS being performed on 101 stifles and 81 stifles. The common dog breeds receiving surgical treatment for MPL were Maltese, Pomeranian, Chihuahua and Poodle. Mean age of dogs with MPL was 32.6 months, and their mean body weight was 4.26 kg. Seventy dogs (52.6%) were male and 63 (47.4%) were female. Of the 182 stifles with MPL, grade II, III and IV were 18.7%, 72.0% and 9.3%. Total complications after TTT and ARS were recorded in 16.8% and 29.6%. Major complications after TTT and ARS were recorded in 5.9% and 12.3%, minor complications after TTT and ARS were recorded in 10.9% and 17.3%. The risk of complication and reluxation rate after TTT were significantly lower than that for ARS (p < 0.05). However, the rate of reluxation among dogs treated by ARS (1.2%) for grade II MPL was significantly lower than that for dogs treated by ARS (8.6%) for grade III MPL (p < 0.05). The TTT group had a shorter recovery period after surgical intervention than that in the ARS group (p < 0.001). In conclusion, TTT had a significantly lower incidence of complication and a shorter recovery period than ARS. However, ARS for grade II MPL appears to be a good surgical option for reducing the rate of reluxation after surgery. These results of this study could be used to provide therapeutic guidelines for surgical MPL correction in small-breed dogs.

Experimental investigation of force-distribution in high-strength bolts in extended end-plate connections

  • Abdalla, K.M.;Abu-Farsakh, G.A.R.;Barakat, S.A.
    • Steel and Composite Structures
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    • v.7 no.2
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    • pp.87-103
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    • 2007
  • This paper presents some of the results from an experimental research project on the behavior of extended end-plate connections subjected to moment conducted at the Structural Laboratory of Jordan University of Science and Technology. Since the connection behavior affects the structural frame response, it must be included in the global analysis and design. In this study, the behavior of six full-scale stiffened and unstiffened cantilever connections of HEA- and IPE-sections has been investigated. Eight high strength bolts were used to connect the extended end-plate to the column flange in each case. Strain gauges were installed inside each of the top six bolts in order to obtain experimentally the actual tension force induced within each bolt. Then the connection behavior is characterized by the tension force in the bolt, extended end-plate behavior, moment-rotation relation, and beam and column strains. Some or all of these characteristics are used by many Standards; therefore, it is essential to predict the global behavior of column-beam connections by their geometrical and mechanical properties. The experimental test results are compared with two theoretical (equal distribution and linear distribution) approaches in order to assess the capabilities and accuracy of the theoretical models. A simple model of the joint is established and the essential parameters to predict its strength and deformational behavior are determined. The equal distribution method reasonably determined the tension forces in the upper two bolts while the linear distribution method underestimated them. The deformation behavior of the tested connections was characterized by separation of the column-flange from the extended end-plate almost down to the level of the upper two bolts of the lower group and below this level the two parts remained in full contact. The neutral axis of the deformed joint is reasonably assumed to pass very close to the line joining the upper two bolts of the lower group. Smooth monotonic moment-rotation relations for the all tested frames were observed.

Movement Patterns for Rising from Supine to Erect Stance in the Third through Eighth Decades (30대에서 80대까지의 똑바로 누운 자세에서 일어서기 운동형태)

  • Bae Sung-Soo;Park Sang-Ock;Yoon Chang-Goo;Kwon Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.8 no.1
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    • pp.65-78
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    • 1996
  • This study wan described the movement patterns when rising from supine to erect stance in the third through eighth decades. Two hundred fifty six subjects, ranging in age from 30 year to 89 were filmed while rising from a supine position. Movement patterns were classified using categorical descriptions of the action of the upper and lower extremity, head-trunk region. This study was designed to determine whether within the rising task the movement patterns of different regions of the body vary with age level and sex, to describe time by subjects to perform this task. The incidence of each movement pattern was calculated and graphed wi th respect to age level and sex. Erect standing time was increased by age increasing in beth sex group. The most common form of rising for subject in the third through fifth decades both sex usually involved symmeytrical push with upper extremity, symmetrical squat pattern with lower extremity, partial rotation pattern wi th head-trunk and symmetrical push to push and reach pattern with upper extremity, symmetri cal squat pattern with lower extremity. partial rotation with head-trunk. In the sixth through eighth decades usually involved symmetrical push to push and reach pattern with upper extremity, symmetrical squat pattern with lower extremity, partial rotation pattern with head-trunk in both sex group.

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The Effect of Myofacial Release and Transcutaneous Electrical Nerve Stimulation on the Range of Motion and Pain in Patient with Chronic Cervical Neck Pain (만성경부통증 환자에 대환 근막이완술과 경피신경 전기자극 치료가 치료기간에 따라 관절가동범위와 통증에 미치는 영향)

  • Seo, Hyun-Kyu;Gong, Won-Tae;Lee, Sang-Yong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.1-12
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    • 2005
  • The purpose of this study is compare the effects of two therapeutic processes-i) conservative Myofacial Release Technique along and ii) Transcutaneous Electrical Nerve stimuliation alone - on the increase in the range of motion(ROM) and on the decrease in patient's pain with chronic Neck pain. The subjects of the study were student with choronic neck pain in Daegu health university. Half of them (10) took conservative Myofacial Release Technique along and the others (10) took Transcutaneous Electrical Nerve stimuliation alone. I used 3D Motion analysis. The range of motion (ROM) in six areas-flexion, extension, left lateral flexion, right lateral flexion, left rotation, right rotation-to check the effectiveness of the two combinations of methods, measured pain with visual analogue scale (VAS) to see the effect on pain reduce. Assement was conducted to the groups before the treatment began and affer the four weeks treatment ended. This study shows that both groups demonstrated significant improvement in ROM increase and pain reduction. Flexion ROM increases were significant in MFR and TENS after treatment 2 weeks and 4 weeks. Extension ROM increases were significant in MFR and TENS after treatment 2 weeks. Right rotation ROM was no significant differences were found in MFR and TENS after treatment all weeks. Right lateral flexion ROM increases were significant in MFR and TENS after treatment 3 weeks. Left lateral flexion ROM increases were significant in MFR and TENS after treatment 1 weeks. But the others no significant differences were in MFR group and TENS group during 4 weeks.

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Influence of Plate Design on the Accuracy of Tibial Alignment after Center of Rotation of Angulation-Based Leveling Osteotomy in Toy-Breed Dogs

  • Han, Jae-Hong;Lee, Hae-Beom;Jeong, Jae-Min;Jeon, Young-Jin;Roh, Yoon-Ho
    • Journal of Veterinary Clinics
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    • v.39 no.3
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    • pp.100-106
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    • 2022
  • The center of rotation of angulation-based leveling osteotomy (CBLO) has been introduced for the stabilization of cranial cruciate ligament rupture (CCLR) in small-breed dogs. This technique can be applied to the tibia without damaging its tuberosity. Although different designs of CBLO plates are available, tibial plateau leveling osteotomy (TPLO) plates have been still used for stabilization during CBLO. To the best of our knowledge, no studies have reported the effects of TPLO plates on the postoperative limb alignment after CBLO. Therefore, the present study (January 2020 to February 2021) aimed to compare the postoperative outcomes (postoperative tibial plateau angle [TPA] and tibial alignment) in patients receiving CBLO and TPLO plates during CBLO. Paired stifle joints (n = 16) were obtained from eight toy-breed cadaver dogs (mean weight, 4.4 kg) that underwent CBLO. The joints were randomly assigned to receive the CBLO (CBLO group) or TPLO plates (TPLO group). Pre-and postoperative radiographs were obtained, and the dissected tibiae were evaluated. The following postoperative parameters were compared to evaluate the surgical outcome: TPA, osteotomy location, mechanical medial proximal tibia angle, inter-segment gap, and tibial plateau translation. No significant differences were found in the postoperative alignment between the two groups. Therefore, TPLO plates may be considered as a viable alternative in toy-breed dogs undergoing CBLO.

Comparative clinical and radiologic evaluation between patients undergoing standard reversed shoulder arthroplasty or bony increased offset

  • Tiago Amorim-Barbosa;Ana Ribau;Helder Fonte;Luis Henrique Barros;Rui Claro
    • Clinics in Shoulder and Elbow
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    • v.26 no.1
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    • pp.3-9
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    • 2023
  • Background: Modifications of the medialized design of Grammont-type reverse shoulder arthroplasty (RSA) using a bony increased offset (BIO-RSA) has shown better clinical results and fewer complications. The aim of this study is to compare the clinical results, complications, and radiological outcomes between patients undergoing standard RSA and BIO-RSA. Methods: A retrospective review was performed of 42 RSA procedures (22 standard RSA and 20 BIO-RSA). With a minimum of 1 year of follow-up, range of motion (ROM), Constant shoulder score (CSS), visual analog scale (VAS), and subjective shoulder score (SSS) were compared. Radiographs and computed tomography (CT) scan were examined for scapular notching, glenoid and humeral fixation, and graft healing. Results: At a mean follow-up of 27.6 months (range, 12-48 months), a significant difference was found for active-internal rotation (P=0.038) and for passive-external rotation (P=0.013), with better results in BIO-RSA. No other differences were found in ROM, CSS (P=0.884), VAS score, and SSS. Graft healing and viability were verified in all patients with CT scan (n=34). The notching rate was 28% in the standard RSA group and 33% in the BIO-RSA group, but the standard RSA had more severe notching (grade 2) than BIO-RSA (P=0.039). No other significative differences were found in glenoid and humeral fixation. Conclusions: Bone-graft lateralization is associated with better internal and external rotation and with less severe scapular notching compared to the standard RSA. Integration of the bone graft occurs effectively, with no relevant changes observed on radiographic evaluation. Level of evidence: III.

The Nocturnal Changes of Plasma Melatonin Concentrations in Night Shift Workers : Comparison of the Clockwise and Counterclockwise Rotational Shift. (야간 근무시의 혈장 멜라토닌의 농도 변화 : 시계 방향과 반시계 방향의 교대근무 비교)

  • Min, Soon;Kim, Mi-Seung;Im, Wook-Bin
    • Journal of Korean Biological Nursing Science
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    • v.2 no.2
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    • pp.81-89
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    • 2000
  • To determine the optimal rotational shift system, the effect of the direction of the rotational work shifting on the nocturnal rhythm of plasma melatonin were investigated in nursing students. Two groups of nine volunteers participated as experimental subjects, and two nursing students participated as a control group. The directions of the rotational work shift were as follows: CW(clockwise)-shift were rotated in the direction of day shift(3 days), evening shift(3 days), off duty(1 day) and night shift(5 days), and CCW(conuterclockwise)-shift were done in the reverse direction. Plasma melatonin concentrations was measured by radioimmunoassay. The results were as follows : The plasma melatonin levels were kept low at night and in the following morning in the CW night shift workers, whereas the level started to increase at 05 : 00 hr in two workers of four CCW shift workers. These result suggests that the shift rotation in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work is somewhat better than CCW rotation for the adaptation to shift work on hormonal aspects in nurses.

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Effect of PNF Neck Patterns on Neck Movement and NDI in Adults with Forward Head Posture (PNF 목 패턴이 전방머리자세를 가진 성인의 목 움직임 및 목 장애 지수에 미치는 영향)

  • Oh, Hyun-Ju;Song, Gui-Bin
    • PNF and Movement
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    • v.14 no.3
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    • pp.177-183
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    • 2016
  • Purpose: The purpose of this study was to investigate the effects of neck patterns in proprioceptive neuromuscular facilitation (PNF) for neck movement and the neck disability index (NDI) among adults with forward head posture. Methods: Thirty-nine subjects were randomly assigned into two groups. Subjects in the proprioceptive neuromuscular facilitation exercise group (PNFG, n = 20) received 20 minutes of PNF neck pattern (flexion-Rt. lateral flexion-Rt. rotation followed by extension-Lt. lateral flexion-Lt. rotation) 3 times weekly for 4 weeks. Outcomes were measured using absolute rotation angle (ARA), anterior weight bearing (AWB), range of flexion and extension motions (RFEM), and neck disability index (NDI) methods before and after the 4-week intervention period. Results: There were significant effects for the PNFG, pre- and post-intervention, in ARA, AWB, RFEM, and NDI. There were significant differences in ARA, AWB, RFEM, and NDI compared with CG. Conclusion: The results of this study suggest the PNF neck pattern could be beneficial for adults with forward head posture.

Effects of Flexion-Extension of Stretching on Craniocervical (스트레칭 굴곡 신전이 두경부에 미치는 영향)

  • Jeon, Ho-Young;Jung, Hyun-Sung;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.1 no.1
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    • pp.109-116
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    • 2006
  • Purpose : To identify the effects of flexion-extension of stretching on the functional improvement of patients with neck myofascial pain syndrome. Methods : the present research investigated 30 patients with neck myofascial syndrome, dividing them into a group doing flexion-extension of stretching. This study examined degree of recovery from neck pain by comparing their neck myofascial pain syndrome before and after the treatment, and compared to find difference in the degree of recovery from myofascial pain syndrome. Results : The results are as follows. For the flexion of stretching, 1. For the visual analogue scale (VAS) decreased significantly for six weeks treatment, 2. For the flexion decreased significantly for six weeks treatment. and the range of motion of cervical vertebrae increased significantly(p>.05). 3. For Stretching, range of motion left rotation indicated significant difference after pre test and after two week but no significant difference after six week. 4. For the left rotation decreased significantly for six weeks treatment. and the range of motion of cervical vertebrae increased significantly(p>.05). 5. For the right rotation decreased significantly for six weeks treatment. and the range of motion of cervical vertebrae increased significantly(p>.05). Conclusion : This study suggest that flexion-extension of stretching have an effect on the functional improvement of patients with neck myofascial pain syndrome.

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