• PNF and Movement
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• 제8권2호
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• pp.57-67
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• 2010

Background and Purpose : Many Physical therapist are inclined to communicate less effectively each other because they hardly use the standard terminology. The purposes of this case report are (1) to apply ICF-based documentation in evaluation (2) to submit the strategy of intervention process to improve the ability of walking short distance of the client who has post-stroke. Description : The client was 44-years-old man with hemiplegia who was in 1 month post-stroke problems were diagnosed while applying the ICF core set. The goals agreed with client were independently walking short distance, stairs and obstacles. To come up with the intervention strategy, hypothesis was set and 4 weeks of intervention was carried out after proposing the short goal and detailed purpose. Outcome : The client's performance in walking short distance and confidence were increased after impairment focused intervention, that are improved in walking velocity, endurance, supporting ability in lower limbs, rhythmical movement in upper limbs and the coordination of both limbs. Activities focused intervention also enhanced the ability in climbing steps and walking around obstacles. Conclusion : The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful.

• 한국전문물리치료학회지
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• 제20권3호
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• pp.89-99
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• 2013

The purposes of this study were: 1) to show the item difficulty hierarchy of walking/moving construct of the International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM), 2) to evaluate the item-level psychometrics for model fit, 3) to describe the relevant physical activity defined by level of activity intensity expressed as Metabolic Equivalent of Tasks (MET), and 4) to explore what extent the empirical activity hierarchy of the ICF-AM is linked to the conceptual model based on the level of energy expenditure described as MET. One hundred and eight participants with lower extremity impairments were examined for the present study. A newly created activity measure, the ICF-AM using an item response theory (IRT) model and computer adaptive testing (CAT) method, has a construct on walking/moving construct. Based on the ICF category of walking and moving, the instrument comprised items corresponding to: walking short distances, walking long distances, walking on different surfaces, walking around objects, climbing, and running. The item difficulty hierarchy was created using Winstep software for 20 items. The Rasch analyses (1-parameter IRT model) were performed on participants with lower extremity injuries who completed the paper and pencil version of walking/moving construct of the ICF-AM. The classification of physical activity can also be performed by the use of METs that is often preferred to determine the level of physical activity. The empirical item hierarchy of walking, climbing, running activities of the ICF-AM instrument was similar to the conceptual activity hierarchy based on the METs. The empirically derived item difficulty hierarchy of the ICF-AM may be useful in developing MET-based activity measure questionnaires. In addition to convenience of applying items to questionnaires, implications of the finding could lead to the use of CAT method without sacrificing the objectivity of physiologic measures.

• 한방재활의학과학회지
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• 제28권3호
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• pp.107-118
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• 2018

In this study, we propose a rehabilitation protocol involving Korean medicine for patients after high tibial osteotomy (HTO) and report its effectiveness. Three patients underwent HTO using the rehabilitation protocol involving Korean medicine. We estimated the outcome evaluating physical examination findings of the knee joint, numeric rating scale, pain disability index, Lysholm knee score, and walking state. After the treatment, we observed that knee movement and muscular strength were improved. In addition, the numeric rating scale, pain disability index, Lysholm knee score, and walking state of patients were improved. Therefore, a rehabilitation protocol involving Korean medicine can be effectively used for patients after HTO. The limitation of this study was the insufficient number of cases and the difficulty of follow-up because of the characteristics of this operation and the long periods of time that are needed for each phase of the protocol. Further studies are needed to design a rehabilitation protocol involving Korean medicine.

• 한방재활의학과학회지
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• 제26권3호
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• pp.153-164
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• 2016

The objective of this study was to propose a rehabilitation protocol for total hip replacement in Korean medicine and to report its effectiveness. Three patients who had undergone total hip replacement were treated using the rehabilitation protocol in Korean medicine. We evaluated the outcome evaluating physical examination findings of the hip joint, numeric rating scale, pain disability index, Harris hip score, and walking state. After the treatment, we observed that hip movement and muscular strength improved. Moreover numeric rating scale, pain disability index, Harris hip score, and walking state of patients improved. A rehabilitation in Korean medicine can be effectively used for total hip replacement patients. The limitation of this study was the insufficient number of cases. Further studies are needed to design a rehabilitation protocol in Korean medicine.

• 한국정밀공학회지
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• 제17권12호
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• pp.169-175
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• 2000

Stable and comfortable walking supports, which can reduce the body weight load partially, are needed for the recovering patients from neurologic disease and orthopedic procedures. In this paper, the development of a manipulator of rehabilitation robot for the patients with walking disabilities are studied. A force controller using pneumatic actuators is designed and implemented to the human friendly rehabilitation robot considering the safety of patients, reliability of the system, effectiveness of the unloading control and economic maintenance of the system. The mechanism of the unloading manipulator is devised to improve the sensibility for the movement of the patients such as direction and velocity. For the unloading force control, fuzzy control algorithm is adopted to reduce the partial body weight and suppress the unwanted fluctuation of the body weight load to the weak legs due to the unnatural working of the patients with walking disabilities. The effectiveness of the force control is experimentally demonstrated.

• PNF and Movement
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• 제16권1호
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• pp.7-17
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• 2018

Purpose: The aim of this study was to investigate the effects of coordinative locomotor training in a chronic stroke patient. Methods: A left hemiplegic patient diagnosed with a right middle cerebral artery stroke participated in this research. The patient's functional conditions were assessed, and a coordinative locomotor training program was initiated to resolve the problems identified. A set of movements deemed difficult based on the brief International Classification of Functioning, Disability and Health core set for stroke and d4501 (long-distance walking) were agreed as improvement targets. The program comprised warm up, main, cool-down, and home exercises. Repeated measurements were obtained, as follows: five times at baseline (A), 10 times during the intervention (B), and five times after the intervention (A). The study period was 7 weeks, and the intervention period was 1 h per day, twice a week for 5 weeks. Various tools, including the community walking test (CWT), 10-m walking test (10 MWT), 6-min walking test (6 MWT), and timed up and go (TUG) test, were conducted to assess the patient's walking ability. Changes in functional domains before and after the ICF Qualifier were compared. The mean values of the descriptive statistics were calculated, and a visual analysis using graphs was used to compare the rates of change. Results: The results showed that the CWT, 10 MWT, 6 MWT, and TUG test scores during the intervention period improved and that this improvement remained, even during the baseline period. In addition, the ICF Qualifier before and after the comparison decreased from moderate to mild. Conclusion: Based on the results, we propose that coordinative locomotor training can have positive effects on community ambulation of chronic stroke patients.

• Journal of Animal Science and Technology
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• 제63권2호
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• pp.440-452
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• 2021

The purpose of this study was to determine if an 8-week therapeutic riding (TR) program was effective in improving the walking ability of students with intellectual disabilities. Thirteen students diagnosed with intellectual disabilities participated in the TR program. TR sessions were conducted twice a week (30 min per session), with a total of 16 rides taking place over an 8-week period. A gait measurement analyzer was used to measure progress based on a turn test (6-m walking and turning test), walk test (10-m walking), and timed up and go (TUG) test. Measurements were made three times: before horse-riding (P0), after 4 weeks (8 rides) of horse-riding (P1), and after 8 weeks (16 rides) of horse-riding (P2). Data analysis was conducted using SPSS software (ver. 22.0). Descriptive statistics were generated on the general characteristics of the subjects, and the Kolmogorov-Smirnov test was used to verify the normality of the data. Because of the lack of normality, the data were analyzed using a nonparametric method and the significance level was set to 0.05. Measurements of the duration of the forward gait cycle (s) in the turn test and the forward gait speed (m/s) in the walk test indicated improved walking ability after the TR program (p < 0.001); the stride length (% height) also increased significantly (p < 0.05). The walk test revealed a significant effect of the program on the duration of the forward gait cycle (p < 0.05), while there were significant improvements on the left and right of the elaborated strides (p < 0.001). No significant improvement in TUG test performance was observed after the TR program. In this study, an 8-week TR program had positive results on gait. Therefore, further research is merited, where TR programs are likely to improve the walking ability of individuals with intellectual disabilities.

• 대한장애인치과학회지
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• 제3권2호
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• pp.97-100
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• 2007

In patients with cerebral palsy, dental treatments, which require absolute patient's corporation, have many difficulties because of muscle spacity, involuntary muscle movements and spasm. Especially in endodontic treatments which very meticulous instrumentation is needed, these muscle discordances may lead to unexpected accidents such as tissue damage while filing, over-instrumentation and swallowing instruments. Also, taking radiographs for measuring canal length is often hindered by walking and movement disorders. This paper is to present a clinical case of one-visit root canal treatment using electrical apex locator under general anesthesia in a cerebral palsy patient.

• 한국전문물리치료학회지
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• 제18권2호
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• pp.35-42
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• 2011

Three hundred and fourteen low back pain patients completed the Korean version of the Oswestry Disability Questionnaire (KODQ) and the Rasch analysis was then applied to identify the inappropriate items and to determine ODQ item difficulties according to a subject's characteristics. For women and youths, the 'sex life' item showed misfit statistics, whereas for older subjects it was the 'pain intensity' and 'standing' items. Also, in the acute low back group the 'pain intensity', 'standing' and 'sex life' items showed misfit statistics. For all subjects, the most difficult item was 'pain intensity', whereas the easiest item was 'walking'. But for the older and acute groups 'lifting' was the most difficult item and for those who have a visual analogue scale score of 3 or less 'sitting' was the most difficult item. These results show that differential item functioning is present in several items according to sex, age, acute and chronic pain, and VAS score. This study may be useful for adjusting the KODQ item difficulties for low back pain patients with different characteristics.

• The Journal of Korean Physical Therapy
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• 제28권5호
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• pp.321-327
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• 2016

Purpose: The purpose was to link items of questionnaires that measure functioning and disability of persons with Low Back Pain (LBP) into the International Classification of Functioning, Disability and Health (ICF). Methods: The Oswestry Disability Index (ODI), Roland and Morris Disability Questionnaire (RM), Fear-Avoidance Beliefs Questionnaire (FABQ), and Short Form-36 health survey (SF-36) were evaluated to map items of those questionnaires into the ICF categories. The linking rule was employed and linking was performed independently by 10 health professionals. One-hundred and two patients with LBP were recruited from 19 medical institutes to this study for a field test to examine relations between the scale and its linked ICF category set. Pearson correlation coefficient was used to analyze their relationships. Results: Walking was only found to be one-to-one linking between the scale and the ICF. Sixty questions in FABQ were to be linked to 9 of ICF categories. Ten and 14 ICF categories were able to be linked to RM and ODI respectively. It was found that majority of items from ODI and RM scale had similar concept and linked to the same ICF category. SF-36 had only 15 categories of the ICF linked. Strong relationship was observed between measurement scales and linked ICF code sets (r=0.79, r=0.65, r=0.47, and r=-0.31 for ODI, RM, FABQ and SF-36 respectively). Conclusion: It was found that commonly used clinical tools for LBP may be linked to ICF. The study results may suggest that clinical data can be standardized to communicate between related professionals.