• Health Policy and Management
• /
• v.34 no.2
• /
• pp.185-195
• /
• 2024

Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

• The Journal of Korean Academy of Sensory Integration
• /
• v.7 no.2
• /
• pp.1-12
• /
• 2009

Objective : The purpose of this study is to find out whether group approach of sensory integration (SI) enhances sensory processing, fine motor function, and social skill for the children with sensory integration disorders. Method : Three children with problems related in sensory integration had got received 21 intervention sessions. We evaluated children with sensory profile(SP), social maturity test, Korean-developmental test of visual perception(K-DTVP), Bruininks-Oseretsky Test of Motor Proficiency(BOTMP) before-and after intervention. The statistical significance of data is tested by the Wilcoxon matched-pair signed rank test. Results : All data of post-intervention did not show any statistically significant differences; SP, social maturity test, K-DTVP, BOTMP. Conclusions : This study is to verify the effect of group SI intervention on sensory processing, fine motor function, and social skill for children with sensory integration disabilities. The results were not statistically significant. However, the average score after SI intervention has been improved in the section of fine motor and social skill comparing to that of pre-intervention period. It would have positive impact for children with sensory integration disabilities. It is needed to study with the larger number of target children and more often treatment session are suggested. The confounding variables also should be controlled in the further study.

• Journal of the HCI Society of Korea
• /
• v.7 no.2
• /
• pp.35-42
• /
• 2012

The purpose of this study was to evaluate the usability of the tablet PC-based Korean high-tech AAC(Augmentative Alternative Communication System) software. In order to develop an AAC software which is appropriate to Korean cultural/linguistic contexts and communication needs of the users, we examined the necessity and ease of use for the communication functions that are required in native Korean communication, such as polite expressions, tense expressions, negative expressions, subject-verb auto-matching, and automatic sentence generation functions, using a scenario-based user testing. We also investigated the users' needs, preferences, and satisfaction for the tablet PC-based Korean high tech AAC using a semi-structured and open questionnaires. The participants of this study were 9 special education teachers, 6 speech therapists, and 6 parents whose children had communication disabilities. The results of the usability testing of the tablet PC-based Korean high-tech AAC software presented positive responses in general, by indicating overall scores of above 4 out of 5 except in tense and negative expressions. The necessity and ease of use in the tense and negative expressions were evaluated relatively low, and it might be related to the inconsistent interface with the polite expressions. In terms of the user interface(UI), there were users' needs for clear visual feedback in the symbol selection and display, consistent interface for all functions, more natural subject-verb auto-matching, and spacing in the text within symbols. The results of the usability testing and users' feedback might serve as a guideline to compensate and improve the function and UI of the existing AAC software.

• Archives of Hand and Microsurgery
• /
• v.23 no.4
• /
• pp.223-229
• /
• 2018

Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

• Journal of the Institute of Convergence Signal Processing
• /
• v.14 no.3
• /
• pp.147-153
• /
• 2013

Functional game, which is the combination of play and learning and a futuristic tool, can minimize the dysfunction and maximize the proper functions, and furthermore, has taken root as a new alternative that can change the game industry and game culture. Recently, the focus of game and education markets is shifting to the development of more advanced learning contents, rather than emphasizing the self-control and motivation of users. Along with that, the game market has excluded the socially dysfunctional elements, such as the addiction and learning disabilities, and has witnessed a diversification into the human-friendly entertainment business that emphasizes the mental and physical health and pursues scientific educational effects. In addition, functional games are expanding its reach from the professional sectors - such as medical aide/medical learning, military simulation, health, auxiliary tools, special education and learning tools - to the realm of routine education, mental health, etc., and has seen a steady growth. However, most functional games, which are being currently planned and developed to cope with the special characteristics of the market, have not undergone accurate scientific assessment of their functions and have not proven their effectiveness. An overwhelming proportion of the functional games are being developed based on the intuition and experience of game developers. Moreover, the type of games, which involve the repetition of simple tasks or take the form of simple puzzles, cannot effectively combine the practically interesting factors and the learning effects. Most games incorporate unscientific methods leading to the vague anticipation of improvement in functions, rather than the assessment of human functions. In this paper, a study was conducted to present the measures that could maximize the effects of functional games in relation to the changes in the visual and auditory stimulations in order to maximize the effects of functional games, i,e., the immersion and concentration. To compare the degree of effects arising from the visual stimulation, the functional game contents made in the form of 2D and 3D were utilized. In addition. ultra sound and 3-dimensional functional game contents were utilized to compare the degree of effects resulting from the changes in the auditory stimulation. The brainwave of the users were measured while conducting the experiments related to the response to the changes in visual and auditory stimulations in 3 steps, and the results of the analysis were compared.

• The Journal of Korean Medicine
• /
• v.25 no.4
• /
• pp.129-138
• /
• 2004

Objective : Treatments for patients with mental retardation and pervasive developmental disorders are not curative, and are designed to help those with disabilities adjust to their environments and daily demands. As clinicians, the present authors tried to find agents with potentially curative properties. Among the numerous herbal formulations available, we chose and assessed Gami-jiwhang-tang (GJT) in the hope that it would improve cognitive development of children. Methods : Subjects were typically-developing healthy, 7- to 8-year-old boys and girls living in Seoul, Korea. The experimental group took GJT for six weeks and was followed up six weeks after discontinuation of GJT. The control group was assessed at the same intervals but did not receive placebos. To measure the effects of GJT, neuropsychological tests and intelligence test were taken before commencing GJT and twelve weeks later. Resulets and Conclusion : For all of the ANOVAs, the treatment by time interaction terms was not significant. However, the experimental group showed the tendency to be progressed in most subscales compared with the control group, especially on performance intelligence, visual organization, and verbal fluency. Conclusion : Although GJT failed to reveal significant improvement in cognition, we remain hopeful about the compound and believe that it should be evaluated by a double-blind, placebo-controlled trial in the future.

• Clinics in Shoulder and Elbow
• /
• v.17 no.4
• /
• pp.175-180
• /
• 2014

Background: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. Methods: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. Results: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder ($8.2{\pm}7.9mm$ versus $7.3{\pm}3.4mm$, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. Conclusions: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.

• 한국HCI학회:학술대회논문집
• /
• 2009.02a
• /
• pp.701-706
• /
• 2009

We proposed the device to control a computer with only a head and eye blinks so that disabilities by car accidents can use a computer. Because they have paralysis of their upper extremities such as C4~C5 paraplegics and cerebral palsy, they cannot efficiently access a general keyboard/mouse not using hands and foots. The cursor position was estimated from a gyro-sensor which can measure head movements, and the mouse event such as click/double click from opto-sensors which can detect eye blinks. The sensor was put on the proper goggle in order not to disturb the visual field. The performance of the proposed device was compared to a general optical mouse, and was used both relative and absolute coordinate in cursor positioning control. The recognition rate of click and double-click was 86% of the optical mouse, the speed of cursor movement by the proposed device was not much different from the mouse. The overall accuracy was 80%. Especially, the relative coordinate is more convenience and accuracy than the absolute coordinate, and can reduce the frequency of reset to prevent the accumulative error.

• Archives of Plastic Surgery
• /
• v.45 no.5
• /
• pp.458-465
• /
• 2018

Background Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. Methods A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. Results The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P<0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. Conclusions Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

• Clinics in Shoulder and Elbow
• /
• v.23 no.1
• /
• pp.20-26
• /
• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.