• Title/Summary/Keyword: Severity of disability

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Difference of Functional Outcome and Related Factors in Patients With Stroke (일부 뇌졸중 환자의 기능변화 및 관련요인)

  • Yi, Seung-Ju;Jeong, Seong-Yeong
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.46-54
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    • 2007
  • The purposes of the present study were to determine the difference of functional outcome, and to identify factors associated with functional difference in patients with stroke. The sample consisted of 56 stroke patients who had received physical therapy at the physical therapy unit of the Dongeui Medical Center in Busan city between January 2000 and June 2002. Stroke patients were evaluated by physical therapists 3 times; The first day in physical therapy (PT) (T1), one month after the first day in PT (T2), and two months after the first day in PT (T3). Functional status was assessed with the Functional Independence Measure (FIM) instrument, a validated instrument for documenting the severity of disability and assessing the outcome of rehabilitation treatment. Functional gain was calculated over T2-T1, T3-T1, and T3-T2. SAS statistical software was used for the analysis. The Student's t-test, paired t-test, analysis of variance (ANOVA/Tukey and Scheffe), and analysis of covariance (ANCOVA) were used to examine the functional difference in variables. Repeated measures ANOVA was also used to analyze the functional difference by time (T1, T2, and T3). Multiple regression analysis was performed to determine the effects of independent variables on the difference of functional outcome as defined by the FIM score. A total of 56 stroke patients were evaluated, their average age${\pm}$standard deviation was $61.6{\pm}9.3$ years (range: 40~81 yr). The functional status of patients who received physical therapy for about 2~3 months was significantly improved (mean FIM scores, $20.5{\pm}1.8$, $28.9{\pm}1.9$, and $8.41{\pm}1.1$ points for each time period, respectively) (p<.0001). Diabetes was significantly associated with the FIM score for T2-T1 (p<.05). The type of diagnosis was significantly associated with the FIM score for T3-T1 (p<.05). Gender, smoking, and the FIM score on admission were significantly associated with the FIM score for T3-T2 (p<.05). In conclusion, gender, smoking, diabetes, the type of diagnosis, and the FIM score on admission were significantly associated with improved FIM scores. We recommend that further research should explore the functional outcome by using larger sample sizes, longer follow-up periods, and more sensitive assessment instruments.

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Phenylketonuria: Current Treatments and Future Developments (페닐케톤뇨증의 치료: 현재와 미래)

  • Lee, Jeongho
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.2
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    • pp.37-43
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    • 2020
  • Phenylketonuria is the most prevalent disorder caused by an inborn error in aminoacid metabolism. It results from mutations in the phenylalanine hydroxylase (PAH) gene. If untreated or late treated, results in profound and irreversible mental disability. Newborn screening test identify patients with phenylketouria. The early initiation of a phenylalanine restricted diet very soon prevents most of the neuropsychiatric complications. However, the diet therapy is difficult to maintain and compliance is poor, especially in adolescents and adulthood. Since 2015, American Medical College of Medical Genetics and Genomics (ACMG) recommended more strong restrictive diet therapy for target blood level of phenylalanine (<360 umol/L). For over four decades the only treatment was a very restrictive low phenylalanine diet. This changed in 2007 with the approval of cofactor therapy (Tetrahydrobiopterin, BH4) which is effective in up to 30% of patients. Data from controlled clinical trials with sapropterin dihydrochloride indicate a similar occurrence of all-cause adverse events with this treatment and placebo. Large neutral aminoacids (LNAA) competes with phenylalanine for transport across the blood-brain-barrier and have a beneficial effect on executive functioning. A new therapy has just been approved that can be effective in most patients with PAH deficiency regardless of their degree of enzyme deficiency or the severity of their phenotype. Phenylalanine ammonia lyase (PAL-PEG) was approved in the USA by FDA in May of 2018 for adult patients with uncontrolled blood phenylalanine concentrations on current treatment. Nucleic acid therapy (therapeutic mRNA or gene therapy) is likely to provide longer term solutions with few side effects.

A Case Report of Glancing Up Motor Tic Disorder Managed by Temporomandibular Joint Balancing Therapy with Korean Medicine Treatment (위로 치켜뜨는 운동 틱 장애 환자에 대해 턱관절균형요법을 병행한 한방치료 치험 1례)

  • Chang Min Shin;Tae Kyung Kim;Eun Ju Lee;Hyun Seob Park;Young Jun Lee;Cheol Hong Kim
    • Journal of TMJ Balancing Medicine
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    • v.13 no.1
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    • pp.21-26
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    • 2023
  • Objectives: The purpose of this study is to report the effect of Korean medical treatment with Temporomandibular Joint Balancing Therapy (TBT) on Tic disorder patient who often glancing up when feels nerves, frightened or tired. Methods: In this study, Tic disorder patient was treated to △△ Korean medicine Hospital from June 12nd, 2022 to July 26th, 2023 by outpatient way. During the clinic period, the patient was treated by Korean medical treatment (acupuncture, cupping, herb medicine), especially using TBT. YGTSS (Yale Global Tic Severity Scale), NDI (Neck Disability Index) and VAS were used for measuring the Tic disorder and neck pain. Results: After treatment for 46 days, the YGTSS showed a decrease from 17 to 3, the VAS associated with Tic disorder also decreased from 6 to 1 and NDI associated with neck pain decreased from 7 to 4. Conclusions: These results showed that Korean medical treatment especially using TBT may have an effect on reducing symptoms of Tic disorder and neck pain. But the further researches are needed.

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Relationship Between Work Ability, Self-efficacy, Work Satisfaction, Sequelae and Workplace Relationships of Reemployed Workers Who Experienced Industrial Accidents (재취업한 산재 노동자의 업무능력, 자기효능감, 직무 만족, 후유증, 동료관계의 구조적 관계)

  • Kim, Do-Hee
    • Journal of Digital Convergence
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    • v.20 no.2
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    • pp.463-477
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    • 2022
  • The current study examined the mediating effect of self-efficacy (SE) in the relationship between work ability (WA) and work satisfaction (WS) perceived by reemployed workers who have experienced industrial accidents based on social cognitive career theory (SCCT), and investigated the effect of Industrial accident sequelae and workplace relationships (WR) on these variables. The data of 976 newly employed workers were selected from the data of the Panel Study of Worker's Compensation Insurance collected in 2018. The data were analyzed by Structural Equation Modeling through SPSS and AMOS programs. It was found that WA had a positive effect on WS through SE. In addition, it was found that the level of pain, the severity of the disability, and the activities of daily living had a negative effect on WS through WA and SE sequentially. Meanwhile, it was found that the WR was affected by the activities of daily living, and had a positive effect on WS through WE. These results emphasize that it is important to provide support to manage sequelae and increase SE in order to help victims of industrial accidents return to the job market and live satisfactorily. It also suggests that SCCT is useful in explaining WS of industrially injured workers.

Oral Health Beliefs According to Oral Health Education Experiences of Middle-aged People, Oral Efficacy, Use of Oral Hygiene Products, relationship with Quality of Life (중년층의 구강건강교육경험에 따른 구강건강신념, 구강효능감, 구강위생용품사용, 삶의 질과의 관련성)

  • Eom, Suk;Choi, Yu-Jin
    • Journal of Convergence for Information Technology
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    • v.10 no.6
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    • pp.156-163
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    • 2020
  • This study made a final analysis of 184 people in their 40s and 50s living in South Gyeongsang Province to identify their relevance to oral health education experiences, oral health beliefs, oral efficacy, oral hygiene product use practices, and quality of life. When there was educational experience in oral efficacy and practice of oral hygiene product use according to oral health education, oral efficacy, oral hygiene product use practice and quality of life was high.In the relationship between oral health belief and oral efficacy, oral hygiene product use practice and quality of life, we could see that oral efficacy and quality of life were low when sensitivity and severity were high among oral health belief, and that oral efficacy and quality of life were high when importance, disability, and benefits were high. Middle age based on oral health care the results over the continuing and developers to develop customized education programs for different target for a longer term recurrent training and future.A Study on the Application through the program will be needed.

The clinical study for hearing handicaps by Goodman classification (Goodman 씨 분류에 따른 청력장애도에 대한 임상적 고찰)

  • 김기령;김영명;정진선;이정권
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.5.2-5
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    • 1977
  • Many persons, both children and adults, suffer from impaired hearing. The handicaps that arise from this are economic, educational and above all, social. These persons need help, both medical and educational. In order to plan facilities for the medical treat ment, the rehabilitation, and the special education required by those with impaired hearing, we must know how many persons with hearing problems there are and the severity of their handicaps. The first step in knowing these is to devide hearing impairent into categories of handicap. Historically, since Beasley (1940) proposed progressive stages of deafness in terms of social disability, there was no well organized classification. of hearing handicap except related material from Huzing (1959) and Silverman (1960). In 1965, Goodman advocated a guide hearing threshold levels and degres of relating hearing impairment. During recent one year, on the bases of Goodman classification of hearing impairment and the report from Illinois Comission on children (1968), we have studied about hearing handicaps and speech life for the 180 cases, who visited to our otolaryngology department with hearing impairment. Now, we report the results of study with the referred references.

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The Correlation between Motor Capacity, Capability, and Performance in Children with Cerebral Palsy (뇌성마비 아동의 능력, 수행능력, 수행 간 상관관계)

  • Kim, JangGon;Kim, TaeYoon
    • 재활복지
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    • v.20 no.3
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    • pp.125-139
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    • 2016
  • The aim of this study was to distinguish 3 concepts(capacity, capability, and performance) for the motor activities of children with cerebral palsy(CP) and examinate relation between capacity(can do in a standardized environment), capability(can do in daily environment), and performance(does do in daily environment). Cross-sectional analysis with a assessment record of children with CP (n=40; 19males, 21 females; mean age 6y 6mo, SD 3y 8mo) was performed. Levels of severity according to the Gross Motor Function Classification System(GMFCS) included level1(13%), level2(10%), level3(43%), level 4(33%), and level 5(3%). Motor activities capacity was assessed by the Gross Motor Function Measure (GMFM-66). Capability and performance were assessed using 2 scales(functional skill, caregiver assistance) of the Pediatric Evaluation of Disability Inventory(PEDI). Correlations between capacity and capability was 0.811(p < .05), and between capability and performance were high(r=0.711, p < .05). And the correlation between capacity and performance is the lowest(r=0.711, p < .05). Motor performance levels are only partly reflected by the motor capacity and motor capability levels in children with CP. Because performance is influenced by Contextual factors (particularly, social factors such as family function). This study suggests that it is necessary to distinguish and evaluate the capacity, capability, and performance in children with cerebral palsy.

Changes in prevalence of obesity according to gender in Korea adults: Using a population-based Korea National Health Check-up Database, 2011-2013 (우리나라 성인의 성별에 따른 비만유병률의 변화 : 국민건강보험 건강검진(2011-2013) 자료 이용)

  • Choi, Oh-Jong;Cho, Sung-Il
    • Korean Public Health Research
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    • v.44 no.4
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    • pp.87-97
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    • 2018
  • Background: Recently, the prevalence of obesity (body mass index [BMI] ${\geq}25kg/m^2$) has been increasing rapidly worldwide over a short period. In Korea, the prevalence of obesity has also increased rapidly due to the rapid socio-economic development and lifestyle changes, with differing patterns according to gender. This study aimed to compare the change in obesity prevalence according to gender among the adult population in Korea using representative data, the National Health Check-up Database (NHCD), to follow-up individuals who had undergone checkups during both years in Korea (2011~2013). Methods: To analyze the changes in obesity prevalence in the recent two years, data regarding men and women who had undergone health check-ups in both two years (2011, 2013) were extracted. The final study population comprised 144,934 persons: 83,604 (58%) males and 61,330 (42%) females. Chi-square test within a univariate analysis, and the level of factor difference was verified with t-test, one-way ANOVA and multiple comparison. Results: In 2011, one out of three participants was obese (BMI ${\geq}25kg/m^2$; male, 37.7%; female, 27.3%) and more than half of the subjects were overweight (BMI ${\geq}23kg/m^2$; male, 65.6%; female, 50.4%) requiring obesity management. For the two years, the BMI of the participants significantly increased (p < .0001) and the prevalence of obesity increased among both males and females. The prevalence of obesity was higher among both genders with a longer duration of smoking, more smoking, family history of hypertension, and family history of diabetes. However, residence, income level, drinking status, psychiatric disorder, disability status and severity of disability were the opposite gender. Conclusion: In the analysis of data, the prevalence of obesity among both men and women was increasing. The degree of change in the prevalence of obesity among men and women was different in each variable. Thus, it will need to consider gender in developing health policies for obesity mediation and to provide integrated healthcare and management for those people.

Proposal of New Criteria for Assessing Respiratory Impairment (새로운 호흡기 장애 판정 기준의 제안)

  • Park, Joo-Hun;Lee, Jae-Seung;Huh, Jin-Won;Oh, Yeon-Mok;Lee, Sang-Do;Lee, Sei-Won;Yoon, Ho-Il;Kim, Deog-Kyeom;Lee, Chang-Hoon;Park, Myung-Jae;Kim, Eun-Kyung;Park, Yong-Bum;Hwang, Yong-Il;Jung, Ki-Suck;Park, Hye-Yoon;Lim, Seong-Yong;Jung, Ji-Ye;Kim, Young-Sam;Kim, Hui-Jung;Rhee, Chin-Kook;Yoon, Hyoung-Kyu;Kim, Young-Kyoon;Kim, Jin-Woo;Yoo, Jee-Hong;Yoo, Kwang-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.3
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    • pp.199-205
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    • 2011
  • Social welfare services for respiratory-disabled persons in Korea are offered based on the respiratory impairment grade, which is determined by 3 clinical parameters; dyspnea, forced expiratory volume in 1 second ($FEV_1$), and arterial oxygen tension. This grading system has several limitations in the objective assessment of respiratory impairment. We reviewed several guidelines for the evaluation of respiratory impairment and relevant articles. Then, we discussed a new grading system with respiratory physicians. Both researchers and respiratory physicians agreed that pulmonary function tests are essential in assessing the severity of respiratory impairment, forced vital capacity (FVC), $FEV_1$ and single breath diffusing capacity ($DL_{co}$) are the primarily recommended tests. In addition, we agreed that arterial blood gas analysis should be reserved for selected patients. In conclusion, we propose a new respiratory impairment grading system utilizing a combination FVC, $FEV_1$ and $DL_{co}$ scores, with more social discussion included.

Correlations between Neurologic and Psychiatric Symptoms in Acute Stroke Patients (급성기 뇌졸중 환자에서 신경 및 정신 증상간 상호관계)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.98-104
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    • 2012
  • Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

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