• Title/Summary/Keyword: outcome measures

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Effects of single-leg stance training of the involved leg on standing balance and mobility in patients with subacute hemiplegia (환측 한발서기 훈련이 아급성기 편마비 환자의 균형과 이동능력에 미치는 영향)

  • Lee, Jin;Lee, Kang-Noh
    • The Journal of Korean Physical Therapy
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    • v.23 no.4
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    • pp.1-6
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    • 2011
  • Purpose: We investigated the effects of single-leg stance training on standing balance and mobility in patients with subacute hemiplegia. Methods: Seventeen matched subjects were assigned randomly to the experimental group or the control group. The experimental group comprising of 8 subjects received single-leg stance training and conventional physical therapy interventions 5 times per week for 4 weeks. The control group comprising of 9 subjects received only conventional physical therapy interventions 5 times per week for 4 weeks. Outcome measures were assessed before and after 4 weeks of intervention using the Berg Balance Scale (BBS), gait speed, and weight bearing index of the affected side. Results: Both the exercise groups showed significant improvements in BBS, gait speed, and weight bearing index (p<0.05). After 4 weeks of intervention, there were statistically significant differences in BBS and weight bearing index between the two groups (p<0.05). Conclusion: These findings suggest that conventional physical therapy interventions along with single-leg stance training could be more effective than conventional physical therapy alone for improving standing balance and mobility in patients with subacute hemiplegia.

An Effective Orientation-based Method and Parameter Space Discretization for Defined Object Segmentation

  • Nguyen, Huy Hoang;Lee, GueeSang;Kim, SooHyung;Yang, HyungJeong
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.7 no.12
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    • pp.3180-3199
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    • 2013
  • While non-predefined object segmentation (NDOS) distinguishes an arbitrary self-assumed object from its background, predefined object segmentation (DOS) pre-specifies the target object. In this paper, a new and novel method to segment predefined objects is presented, by globally optimizing an orientation-based objective function that measures the fitness of the object boundary, in a discretized parameter space. A specific object is explicitly described by normalized discrete sets of boundary points and corresponding normal vectors with respect to its plane shape. The orientation factor provides robust distinctness for target objects. By considering the order of transformation elements, and their dependency on the derived over-segmentation outcome, the domain of translations and scales is efficiently discretized. A branch and bound algorithm is used to determine the transformation parameters of a shape model corresponding to a target object in an image. The results tested on the PASCAL dataset show a considerable achievement in solving complex backgrounds and unclear boundary images.

Review of Economic Evaluation Studies for Drug Reimbursement Decision (의약품 보험급여 결정을 위한 경제성평가 연구의 평가)

  • Choi Sang-Eun;Sullivan Sean D.
    • Health Policy and Management
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    • v.15 no.4
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    • pp.1-25
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    • 2005
  • Legislation on pharmaceutical reimbursement decision using economic evaluation results was made in Korea in fm, but has yet to be fully implemented. We evaluated the quality of Korean economic evaluation studies of pharmaceuticals to understand gaps between legislation and implementation. From this evaluation, we propose policy options that might strengthen the research Infrastructure In order to support such studies. We reviewed 23 published studies for drugs conducted between 1996 and 2004. Evaluation criteria included methodological characteristics, healthcare system characteristics, population characteristics, and applicability of results. Large variation in study quality was observed, particularly with study design, outcome data, treatment patterns and interpretation. Korean clinical data used was mostly from observational studies of 1-2 hospitals. Foreign data was extracted from clinical trials that did not Include Asian population and their selection criterion was not clarified. With respect to treatment patterns, medical records and hospital bills were used without adjustment regarding area, hospital type, and others. And next frequent situation relied on expert opinion from academic physicians in specialty practice. preference measures, when used, were not elicited from the Korean population. $78.3\%$ of studies did not clarify the funding source. If the Korean economic evaluation policy is to provide meaningful data for decision makers, the quality of cost-effectiveness studies will need to improve dramatically. This may involve access to or creation of better data, more diverse funding, unproved training of researchers and evaluators, and partnerships with technology manufacturers.

Comparison of the Surface Electromyographic Signal of Progressive Resistance Increase and Progressive Resistance Decrease Exercise (점진적 저항증가와 점진적 저항감소 운동에서의 표면 근전도 신호 비교)

  • Han, Kyoung-Ju;Choi, Bo-Kyung
    • The Journal of Korean Physical Therapy
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    • v.20 no.1
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    • pp.11-16
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    • 2008
  • Purpose: This study was undertaken to compare the signal characteristics of surface electromyography (EMG) between progressive resistive increase exercise (PRIE) and progressive resistive decrease exercise (PRDE). Methods: Forty healthy male subjects were randomly assigned to either the PRIE group or the PRDE group. Subjects participated in the PRIE and PRDE methods, with 10 RM for each subject. EMG activity was recorded from the rectus femoris muscle. Outcome data were collected for both groups pre-exercise, immediately post-exercise, then at 5 and 10 minutes post-exercise. Repeated measures 2-way ANOVA was used to determine the statistical difference of the root mean square (RMS) in EMG activity. Results: We showed that RMS values, when compared with pre-exercise, were decreased immediately after exercise and were increased at 5 and 10 minutes after exercise (p<0.05). The RMS values were not significantly different between the two groups (p>0.05). Conclusion: These results can indicate that both the PRIE and PRDE protocols will be improve strength with equivalent efficacy. Further studies are needed to address exercise duration, frequency of exercise sessions, and rest times than the PRIE and PRDE protocols with regard to the changes in strength improvement without a large amount of muscle fatigue.

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The Effect of a Proximal and Distal Tibiofibular Joint Manipulation on Dorsiflexion and Balance in Individuals with a History of Lateral Ankle Sprain

  • Chae, Yun-Won;Park, Ji-Won;Nam, Ki-Seok
    • The Journal of Korean Physical Therapy
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    • v.29 no.2
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    • pp.95-100
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    • 2017
  • Purpose: This study aimed to evaluate the changes in dorsiflexion and balance following proximal and distal tibiofibular joint manipulation in individuals with a history of lateral ankle sprain (LAS). Methods: Fifteen participants with a history of unilateral LAS, exhibiting a restriction in ankle dorsiflexion were included in this study. LAS ankle received a manipulation to the proximal and distal tibiofibular joint, while the opposite control ankle received no manipulation intervention. The outcome measures included ankle dorsiflexion and balance. Ankle dorsiflexion was measured using weight-bearing lunge test. Static and dynamic balances were measured using the overall, anterioposterior, and mediolateral balance index via the biodex balance system. Measurements were obtained prior to and following manipulation. Results: This study showed that ankle dorsiflexion and dynamic balance were improved following the manipulation compared to those prior to the manipulation (p<0.05). There was no significant change in static balance (p>0.05). Conclusion: The joint manipulation technique applied to the ankle of those with a history of LAS appears to improve ankle dorsiflexion and dynamic balance. This suggest that a manipulation to the proximal and distal tibiofibular joint could be provided as preliminary data regarding the prophylactic effects of recurrent LAS.

Vestibular Evoked Myogenic Potentials in Supratentorial Infarction Patients (천막위 뇌경색 환자에서 전정유발근육전위)

  • Kim, Kwang-Ki;Lee, Seung Hwan;Lee, Seo-Yeong;Son, Hong Seok;Kim, Sung Hun
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.53-57
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    • 2006
  • Background: Vstibular evoked myogenic potentials(VEMP) have been known to be useful documenting abnormality in patients with various vestibular disorders and brainstem lesions but the studies of VEMP in patients with hemispheric lesions are rare. Methods: We recorded VEMP in 21 consecutive patients with acute ischemic stroke in the supratentorial lesions without evidence of brainstem or vestibular end organ lesions. All patients underwent magnetic resonance imaging and the main outcome measures of VEMP were recorded in all subjects. We interpreted each parameters of VEMP using our normal laboratory data. Results: VEMP abnormalities(prolonged latency or asymmetry of amplitude) were found in 57%(12/21) of acute infarction patients with supratentorial lesions. Bilateral VEMP abnormalities were found in six patients and unilateral abnormalities were found in another six patients with ipsilateral abnormalities in the three and controlateral abnormalities in the three patients. Conclusions: VEMP abnormalities were found in supratentorial stroke patients in our studies and this findings suggest supranuclear control may affect the generation of VEMP potentials.

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Meta-Analysis of Constraint-Induced Movement Therapy in Hemiplegic Stroke Patient in Korea (국내 뇌졸중 편마비 환자를 대상으로 한 건측억제-환측유도 치료효과의 메타분석)

  • Park, So-Yeon;Shin, In-Soo
    • Physical Therapy Korea
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    • v.19 no.2
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    • pp.59-68
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    • 2012
  • This meta-analysis investigated the effects on arm motor impairment, arm motor function and disability, and psychological aspects of constraint-induced movement therapy (CIMT) for upper extremity hemiparesis following stroke, based on Korean studies. A comprehensive search of the complete Korean studies information service system (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database to September 2011 was conducted. Eleven eligible controlled clinical trials compared CIMT to a control group or an alternative treatment. All outcome measures of arm motor impairment, arm motor function and disability, and psychological aspects were pooled for calculating effect size. The overall effect size of CIMT was .700 (95% confidence interval=.482~.918). The CIMT programs showed large effect on the aspect of arm motor function and disability (the effect size is .920) and the psychological aspect (the effect size is .946). The effect of CIMT on arm motor impairment was moderate (the effect size is .588). These results show that CIMT may improve upper extremity motor impairment, function and disability, and psychological aspects following stroke. However, these results were based on a small number of studies, and not all of them were randomized control trials. Additional research is needed to include larger well-designed trials to resolve these uncertainties.

The Effects of Treatment With a TETRAX on Balance and Mobility in Acute Stroke Patients (균형능력 운동치료 시스템을 이용한 치료가 급성기 뇌졸중 환자의 균형과 이동능력에 미치는 영향)

  • Lee, Nam-Hyun;Lee, Jin;Lee, Kang-Noh
    • Physical Therapy Korea
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    • v.17 no.3
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    • pp.11-19
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    • 2010
  • The purpose of the study was to determine the effects of balance training with 'TETRAX' system, a balance training and assessment tool, on balance and mobility in acute hemiplegic patients. Nineteen matched subjects were assigned randomly into either an experimental group or a control group. An experimental group with 10 subjects received balance training with 'TETRAX' exercise program and conventional physical therapy interventions 5 times per week during 4 weeks. A control group with 9 subjects received conventional physical therapy interventions 5 times per week during 4 weeks. Outcome measures were taken before and after 4 weeks of interventions using the Stroke Rehabilitation Assessment of Movement (STREAM), the Berg Balance Scale (BBS), gait speed, and the fall down index. Results indicated that both exercise groups improved significantly in STREAM, BBS, and gait speed (p<.05). The experimental group had a little improvement than the control group. Both exercise groups did not show statistical significance in fall down index (p<.05). Following 4 weeks of intervention, except gait speed there was no statistically significant difference between two groups. However, these findings suggest that conventional physical therapy interventions with visual feedback training could be effective on improving balance and mobility than conventional physical therapy alone in acute hemiplegic patients.

Retrospective Drugs Utilization Review Study for Chronic Kidney Disease Using National Health Insurance Database (건강보험 자료를 이용한 만성신부전 환자의 신독성 약물사용 현황)

  • Kim, Dong-Sook;Lee, Hyun-Jeong;Son, In-Ja;Kim, Gui-Sook;Shin, Joo-Young;Lee, Kun-Sei
    • YAKHAK HOEJI
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    • v.53 no.3
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    • pp.138-144
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    • 2009
  • The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

Effects of Dynamic Balance Training on Pain, Physical Function, and Balance Ability in Patients with Chronic Knee Osteoarthritis (동적 균형 훈련이 만성 슬관절 관절염 환자의 통증, 신체 기능과 균형 능력에 미치는 영향)

  • Bang, Dae-Hyouk;Bong, Soon-Young
    • PNF and Movement
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    • v.16 no.1
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    • pp.105-113
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    • 2018
  • Purpose: The aim of this study was to explore the effects of dynamic balance training on pain, physical function, and dynamic balance in individuals with knee osteoarthritis. Methods: Fourteen patients with knee osteoarthritis participated in this study. The patients were randomly assigned to two groups: an experimental group (n=7) or a control group (n=7). All the patients took part in a lower extremity strength program for 30 min. In addition, the experimental group participated in a 30-min dynamic balance program. Both groups performed the program five times a week for 3 weeks. Outcomes, including the numeric rating scale (NRS), Western Ontario and MacMaster Universities Arthritis Index (WOMAC), and Community Balance and Mobility Scale (CB&M), were measured at baseline and after 3 weeks. Results: Both groups showed pre-to-post intervention improvements on all outcome measures (p<0.05). The experimental group showed a significant improvement in WOMAC (p = 0.00; Z = -2.82) and CB&M (p = 0.03; Z = -2.20) scores after the intervention as compared with those of the control group. Conclusion: The results revealed that dynamic balance training improved physical function, as well as balance ability, in patients with knee osteoarthritis as compared with that of a control group with no balance training.