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Effects of game-based balance training with constraint-induced movement therapy on lower extremity function and balance confidence levels in women with total knee replacement

  • Choi, Ho-Suk;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
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    • v.8 no.1
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    • pp.8-14
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    • 2019
  • Objective: Degenerative knee arthritis is the most common disease that occurs in older people. Constriction-induced movement therapy (CIMT) has been reported to be as an effective treatment for the impairments, such as asymmetric weight-bearing and reduced balance that occurs after receiving a total knee replacement (TKR). Game-based rehabilitation training for persons with TKR is interesting and provides a variety of feedback. Design: Randomized controlled trial. Methods: Thirty-six subjects with TKR were randomly assigned to either the CIMT game training (n=12), general game training (n=12), or the control (n=12) group. Each group underwent twelve sessions (30 min/d, 3 d/wk for 4 weeks). In the CIMT game training group, the application of CIMT adjusted the weight of the pressure delivered from the two boards used in Wii games. In the general game training group, the game was played without adjusting the weight of pressure. The game training used the Wii Fit's Ski Slalom application. Subjects were assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Activities-specific Balance Confidence (ABC) Scale. Results: All three groups showed significant improvements in pain, stiffness and physical function, total WOMAC scores, and ABC scores after the intervention (p<0.05). Significant differences were observed in physical function, total WOMAC scores, and ABC scores of the CIMT game training group compared with the other groups (p<0.05). Conclusions: The CIMT game training and general game training exhibited improvements on stiffness, but the CIMT game training exhibited a larger effect on lower extremity function and balance confidence levels.

A Qualitative Study on the Interpersonal Trauma Experience in Counseling Psychology Major University Students and their Growth Process as Counselors (상담심리전공 대학생의 대인 외상 경험과 상담자로서의 성장 과정에 대한 질적 연구)

  • Hong, Ye Young;Chang, Eun Jin
    • Journal of Convergence for Information Technology
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    • v.9 no.5
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    • pp.147-157
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    • 2019
  • In this study, we focused on the experience of interpersonal trauma among university students majoring in counseling psychology to understand the meaning of the trauma they experienced, and analyzed the process of their growth as counselors. To that end, we conducted a survey on interpersonal trauma and post-traumatic growth, and interviewed final six students in a face-to-face interview, and analyzed the collected data using the method of qualitative case study. As a result, the trauma and subsequent growth experience have been categorized into 38 semantic units, 15 subcategories and 5 categories, including 'Times of pain', 'A life of dealing with complex emotions alone', 'An experience of understanding and being understood', 'Attempts to change and new meanings' and 'Worries and expectations of growth as a counselor'. The results of this study are meaningful in providing basic information and educational materials needed for the intervention of students majoring in counseling psychology who have experienced trauma.

The Effects of Muscle Energy Technique on the Shoulder Complex Range of Motion and Posture Alignment of Female College Students in their Twenties with a Round Shoulder (근에너지기법이 둥근어깨를 가진 20대 여대생의 어깨복합체 가동성과 자세정렬에 미치는 영향)

  • Im, Gyeong-eun;Jeong, Yeon-woo;Seo, Tae-hwa
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.2
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    • pp.17-25
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    • 2021
  • Background: The purpose of this study is to investigate basic data about the effects of muscle energy technique on the shoulder complex range of motion and posture alignment in the round shoulder posture. Methods: The subjects included 15 women that gave consent to participate in the study voluntarily. They performed the muscle energy technique for 30 minutes twice. The round shoulder posture was measured with a straight edge ruler. The shoulder complex range of motion was measured with the apley scratch test. The forward head posture was measured with ImageJ. The pectoralis minor muscle length was measured with a tape measure. Results: There were statistically significant differences in the round shoulder posture both right and left (p<.05). The experiment group showed statistically significant differences in the pectoralis minor muscle length (p<.05). There were significant differences in the shoulder complex range of motion including flexion, left lateral flexion, right lateral flexion, left side bending, and right side bending (p<.05), but no significant differences were found in extension (p>.05). The forward head posture showed significant differences in CVA changes (p<.05) and no significant differences in CRA changes (p>.05). Conclusion: These findings demonstrate that the muscle energy technique relaxed muscles around the shoulders and increased the shoulder complex range of motion. The technique is also expected to prevent pain in the neck and shoulders and lower injury risk. In conclusion, the muscle energy technique can be applied as an effective intervention for round shoulder posture.

Effect of Knee Stabilization Exercise on Balance and Walking Ability in Patients with Total Knee Replacement (무릎관절 전치환술 환자에게 적용한 무릎 안정화 운동이 균형과 보행능력에 미치는 영향)

  • Park, Geun-hong;Kim, Tae-won;Song, Hyoung-bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.2
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    • pp.69-76
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    • 2021
  • Background: Degenerative arthritis accounts for a large portion of the elderly, causing a lot of inconvenience in daily life. Total knee replacement (TKR) are performed to relieve pain in the knee joint. The purpose of this study was to determine whether knee joint stabilization exercises are effective in improving balance and walking ability in degenerative arthritis patients who have undergone TKR. Methods: A total of 30 TKR patients participated in this study. They were assigned to two groups. The experimental group, the group that underwent knee stabilization exercises, joint mobilization and general physical therapy. On the other hand, and the controlled group, the group that underwent joint mobilization and general physical therapy. All exercises were conducted thrice a week, for four weeks. The main balance outcomes were evaluated using the posture balance training system, while walking ability was assessed using a wireless 3-axis accelerometer. Results: The experimental group had significantly higher scores in postural stability testing (PST), limits stability testing, and waling ability. The post-intervention evaluation, there were significant differences in all variables between the two groups. However, no significant difference was noted in the foam eyes closed test in PST. Conclusion: This study suggests that knee joint stabilization exercises effectively improve the balance and walking ability of TKR patients. Thus, it could be presented as useful in clinical practice.

The effect of positive family relationship on post-traumatic growth in cancer patients - moderating effect of spiritual sensitivity - (암 환자의 긍정적 가족관계가 외상 후 성장에 미치는 영향 - 영적민감성의 조절효과-)

  • Kim, Jae Yop;Hwang, Ho Kyung;Choi, Yu il;Lee, Hyun
    • Journal of Family Relations
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    • v.22 no.4
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    • pp.223-238
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    • 2018
  • Objectives: The purpose of this study was a) to examine the effect of positive family relationships on post-traumatic growth in cancer patients, and b) to verify the moderating effect of spiritual sensitivity. Methods: The subjects were cancer patients, both outpatients and inpatients selected from major hospitals specialized in cancer treatment using judgement sampling. A self-administered questionnaire survey was given to cancer patients, and a total of 208 cases were collected but only 201 cases were used in the final analysis due to seven unclear and inadequate questionnaires. We performed descriptive statistics to identify the prevalence for each variable, and the moderating effect was verified through multiple regression analysis. Results: The main results are as follows. First, the average post-traumatic growth of the subjects was 3.01 (0-5 points). Second, the positive family relations of the subjects were 2.58 (0-5 points) and the average of spiritual sensitivity was 2.93 (1-5 points). Third, positive family relationship of cancer patients was positively correlated to post-traumatic growth, and spiritual sensitivity was verified as a moderator to positive family relationship enhancing the post -traumatic growth. Conclusion: These findings imply the importance of post-traumatic growth in cancer patients as a key intervention point to overcome pain and frustration from cancer. We suggest to develop family therapy programs and services aimed at fostering positive family relationships and meeting the needs of spiritual sensitivity for cancer patients and their families. This study also provides ways to promote post-traumatic growth in social welfare facilities in medical institutions and religious foundations.

The Problem of Self-Limitation in Therapeutic Culture: Focusing on Misery Memoirs (치유문화에서 나타나는 자아 제한성의 문제: 고통수기들을 중심으로)

  • Seoh, Gilwan
    • English & American cultural studies
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    • v.14 no.1
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    • pp.73-94
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    • 2014
  • Accounts from therapeutic culture seem often to associate the selfish, or at least self-centered quest for self-fulfillment with individual choice or satisfaction, self-expression, expressive individualism, and emotionalism. These associations point to the downside of therapy as they present it as constituting a culture of narcissism, selfishness, or irresponsibility. While some of these characterizations contain useful insights, they overlook what are maybe some of the most important features of a therapeutic outlook. This paper aims to reveal that the therapeutic imperative is not so much geared towards the realization of self-fulfillment, as it is the promotion of self-limitation. Therapeutic culture tends to posit the self in a fragile and feeble form and insist that the management of life requires the continuous intervention of therapeutic expertise. Because of this, the elevated concern with the self is underpinned by anxiety, pain, suffering, and survival, rather than seen as a positive vision of realizing the human potential. Therapeutic culture has in this way helped to construct a diminished sense of self by which one is seen as suffering from an emotional deficit and vulnerability. This paper demonstrates this downside of therapeutic culture concerning self-limitation and the sense of a diminished self by examining popular "misery memoirs." Misery memoirs are widely consumed by the general public, therefore tend to be treated by contemporary therapeutic culture as a gospel on the therapeutic ideal for self-fulfillment and self-discovery. This is, despite the existence of hidden evidence to the contrary, because of their redemptive, happy endings that show individuals overcoming difficult trials such as child abuse, incestuous rape, and domestic violence. Individual self-fulfillment and self-discovery in such stories are not achieved through the active agency of the subject but through the passive endurance of pathological symptoms and with the aid of expertise and outside support. Therefore, such stories put victims in the limited position.

Research trends and clinical applications of neural mobilization in Korea: A scoping review (신경가동술의 국내 연구 동향과 임상적 활용: 주제범위 문헌고찰)

  • Lee, Eun-Kyung;Kim, Jin-Hyun;Lee, Jung-Han;Cho, Eun-Byul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.1
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    • pp.53-66
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    • 2021
  • Objectives The purpose of this scoping review is to investigate the trends and gaps in existing research on neural mobilization in Korea and to suggest further directions for study. Methods A scoping review was sequentially conducted according to the five steps outlined by Arksey and O'Malley, and the PRISMA-ScR checklist. We searched five domestic databases (RISS, DBpia, KISS, ScienceON, and KMBASE) and identified relevant literature reported until April 15, 2021. The key search terms used were "Neural mobilization" and "Neurodynamic". Results Of the 1383 studies identified in the search, 50 were finally selected. Of these, 45 studies were in the field of medicine and pharmacy and physical therapy as the most common sub-field. Thirty-eight of the 50 studies (76%) were randomized controlled trials. Neural mobilization was most frequently used in the treatment of stroke (n = 13) and of various neuromusculoskeletal diseases such as cervical radiculopathy (n = 8) and low back pain (n = 5). The main targets of neural mobilization were the median nerve (n = 20) and sciatic nerve (n = 14). The most commonly used technique for neural mobilization was that developed by Butler and Jones in 1991 (n = 10). Conclusions This is the first scoping review of neural mobilization in Korea. We believe that further research on neural mobilization with other types of research design is necessary to investigate the utility of neural mobilization and to establish standard protocols. Our findings indicate that neural mobilization can be considered as an intervention for neuromusculoskeletal diseases in Korean medicine.

A Study on the Characteristics of the Awareness and Satisfication Level of Musculoskeletal Patients and Non-Musculoskeletal Patients that Use Korean Medical Institutions (한방의료기관 이용자 중 근골격계질환자와 비근골격계질환자의 인식도 및 만족도 특성연구)

  • Sung, Angela Dongmin;Choi, Sung Young;Park, Minjung;Sung, Soo-Hyung
    • Journal of Society of Preventive Korean Medicine
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    • v.24 no.3
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    • pp.27-38
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    • 2020
  • Background : The study aimed at examining the awareness and satisfaction level of Korean medicine treatment of musculoskeletal patients and non-musculoskeletal patients. Method : The frequency and percentage were calculated to identify the overall characteristics, and to identify the characteristics of the respondents who visited the hospital to treat musculoskeletal diseases and those who visited for the treatment of non-musculoskeletal diseases, the correlation between the variables was analyzed using the chi-square analysis (χ2-test). Furthermore, analysis items were compared depending on detailed diseases within the musculoskeletal disorder (lumbar pain, sprains, arthritis, frozen shoulders, spondylitis, disc) Result : Respondents who used Korean medicine for the purpose of treating musculoskeletal diseases had answered that costs involved in Korean medicine was expensive, and answered that herbal decoction was the preferred Korean medicine treating method for expanding health insurance benefits. Regarding the safety awareness of Korean medicinal herbs, responses that said it was safe was high, and their willingness to use and recommend Korean medicine in future was also high. Respondents who used Korean medicine for the purpose of treating musculoskeletal diseases said they were overall satisfied along with the attitude of Korean medical doctors, treatment results, and costs of treatments. Conclusion : The study was aimed at securing basic data to indirectly identify the national demand for Korean medicine, through investigating the level and degree of differences that exist in the perception and satisfication level and further find a point where policy intervention is possible in future.

Success rate of nitrous oxide-oxygen procedural sedation in dental patients: systematic review and meta-analysis

  • Rossit, Marco;Gil-Manich, Victor;Ribera-Uribe, Jose Manuel
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.6
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    • pp.527-545
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    • 2021
  • The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

A Scoping Review for Economic Evaluation of Korean Medicine for Whiplash Associated Disorders (교통사고 상해증후군의 한의치료에 대한 경제성평가를 위한 주제범위 문헌고찰)

  • Kang, Shin-Woo;Hwang, Yun Gyeong;Hwang, Man-Suk;Lee, Hye-Yoon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.97-105
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    • 2021
  • Objectives This study is aimed to evaluate cost-effectiveness of treatment of Korean Medicine for whiplash associated disorders (WAD) and to suggest the direction of future research. Methods We searched papers in Pubmed database to use some keywords indicating whiplash injury syndrome, treatment of Korean Medicine and cost-effectiveness. After searching, appropriate papers were selected depending on the exclusion criteria. The selected papers were analyzed in the sections of author, publication year, intervention and control groups, outcome measurement, the list including in the cost, cost-effectiveness, cost-utility and study design. Results Four studies about effect of Korean medicine and 3 studies about economic evaluation were finally included. Acupuncture was effective for balance disorder and neck pain. Economic evaluation studies used analytical decision model or cost-consequence analysis. Cost-effectiveness analysis using visual analog scale and cost-utility analysis using quality adjusted life years were performed. Initiating timing of proper management affected the consequence of treatments. Direct and indirect medical costs including supportive devices, and non-medical costs such as litigation were considered. Conclusions We conclude that studies haven't been conducted so far to evaluate the cost-effectiveness of Korean Medicine in whiplash injury syndrome. Thus, future studies are needed in this section.